Poison the Pain – Botox for Migraines

Botox can make you look better. Did you know it could also make you feel better? Moreover, we are not just talking about self-esteem here. Migraineurs looking to smooth out some wrinkles in their foreheads discovered a happy side effect of the cosmetic treatmentfewer migraines.

Botox, botulinum toxin type A, is a neurotoxin most famous for its use in smoothing wrinkles. The FDA originally approved it in 1989 as a treatment for eye muscle disorders, and the cosmetic use came later.

Botox is thought to work by weakening or paralyzing the muscles by stopping or slowing the release of the neurotransmitter acetylcholine (ACh). ACh transmit the signal from nerve to nerve to cause muscle contraction. When ACh production is inhibited muscles relax, including those that cause wrinkles.

Acetylcholine is also a neuromodulator. This means it affects how other neurotransmitters function. ACh alternately excites and sedates nerve endings, and it is this ability to suppress excitability that may help migraine patients. One theory on migraine causes is based on the idea of a cascade of nerve excitement in the brain that agitates the arteries in the brain. This in turn stimulates nerve sensitivity, which further inflames the artery, in a vicious circle.

Botulinum toxin is the same agent produced by spoiled food that causes botulism. When used medically, the toxin is injected straight into the muscles and not absorbed into the bloodstream. The dose of toxin required to cause botulism is significantly larger than used in medical applications.

Like most prophylactic migraine treatments, Botox injections may take several weeks to become effective. Depending on the study, Botox has proven effective at reducing migraines for 60-90% of study participants. Injections should be given at least three months apart and the effects should last ten to thirteen weeks. Botox is not currently FDA approved as a migraine treatment.

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