Magazine article Clinical Psychiatry News

Botox Stops Headache Pain in Recalcitrant Cases

Magazine article Clinical Psychiatry News

Botox Stops Headache Pain in Recalcitrant Cases

Article excerpt

CHICAGO -- A new study, the largest to date, adds to the evidence that botulinum toxin type A alleviates and prevents headache pain.

Botulinum toxin type A (Botox) is an effective preventive therapy for headache pain in a variety of patients with primary headache disorder, including those unresponsive to oral preventive agents, according to a poster presented at the annual meeting of the American Headache Society.

The open-label, retrospective study included 271 patients with migraine or tension-type headaches; all required preventive treatment, and three-quarters had tried several other therapies without success; 48% had been overusing oral agents in an effort to achieve pain relief.

"Many of these patients otherwise would be left with narcotics as their best option," Dr. Andrew M. Blumenfeld, principal investigator and chief of neurology at Kaiser Permanente San Diego, said in a statement. "Our study also shows Botox causes fewer side effects than many of the standard medications."

About 80% of the patients said their headaches were less frequent, less intense, or both after Botox therapy; 60.5% (164) reported good to excellent pain relief, 19.5% (53) reported some pain relief, and 19.9% (54) reported no relief. Overall, Botox therapy led to a significant 56% reduction of headache days per month from baseline (from 18.9 to 8.3 days). Headache intensity decreased 25% from baseline (from 2.4 to 1.8 points on a 0-3 scale).

Patients were treated every 3 months, with a minimum of two treatments and a maximum of five. A "fixed-site" injection approach was used for those with migraine or migrainous features, a "follow-the-pain" approach was used for those with tension features, and a combination of both was used for patients with both headache features. …

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