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For years I have suffered from debilitating migraines. I’ve tried preventative medication and I also have medication to take at the onset of a migraine. Last year, my neurologist suggested that I start Botox. I agreed to give it a try, what’s the worst that could happen? I got the worst cluster migraines after the injections and was in bed for days. I continued with three more cycles of Botox but the Medrol Dose Pack that they prescribed me to stop the cluster migraines made my anxiety one hundred times worse. Ultimately, I stopped the Botox and dealt with the migraines.

I had an appointment two months ago with my neurologist before the weather goes up and down like it does in spring. The barometric pressure is a huge trigger for my migraines. The neurologist suggested that I try Botox again. I was very hesitant because of how horrible it made me feel last year, but I agreed to try at least one month of it. Migraines make my anxiety and depression much worse. So I figured it was probably a good idea to give it a try again. You are supposed to get it done every 90 days with check-ups in between. This morning I went in and had all of the Botox injections. They gave me a prescription for Medrol Dose Pack incase I need it, but hopefully I won’t this time around. Here are the places they inject the Botox for chronic migraine suffers:

According to the American Migraine Foundation:

What Type of Headache Responds Best to Botox?

Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month.  “The more frequent the headaches, the better the patient does with Botox,” says Dr. Andrew Blumenfeld, Director, The Headache Center of Southern California. Botox is not recommended for patients who experience fewer than 15 headache days a month.

What is Botox?

Botox is a form of botulinum toxin, a neurotoxin produced by the bacteria that causes botulism. When the Botox botulinum toxin is purified and used in tiny doses in specific areas, it temporarily reduces muscle contractions for approximately 3 months.

How Does Botox Work?

Botox is injected around pain fibers that are involved in headaches. Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission. This prevents activation of pain networks in the brain.

Botox prevents migraine headaches before they start, but takes time to work. “I look to the second and third treatments to maximize effects,” says Dr. Andrew Blumenfeld. “Patients see increasing benefit with an increase in the number of treatment cycles.” One treatment lasts for 10-12 weeks, and patients reported that two Botox treatments reduced the number of headache days by approximately 50%.

Who Uses Botox?

The FDA approves the use of Botox to treat chronic migraine in adults who are age 18 or over.  Botox is considered an “off-label” treatment if it’s used for children or adolescents. This means that a doctor can prescribe it, but insurance companies might not pay for it.

Getting Botox Treatment Paid for by Insurance

In general, the FDA-recommended dosage of 155 units costs between $300 to $600 for each treatment. Because Botox is FDA approved for chronic migraine, it’s covered by most plans, including Medicare and Medicaid. Allergan offers a “Botox Savings Card,” which offers patients reduced fees.

Please note that before your insurance company will approve Botox as a treatment for your chronic migraine, you typically must have tried and failed to respond to two other preventative treatments. These might include anti-seizure medications, antidepressants, or blood pressure medications that are typically used to prevent migraine.

What is Treatment Like?

When you receive your first Botox treatment, expect the appointment to take about 20 minutes. The doctor uses a very small needle that feels like a pinprick. He or she injects small amounts of Botox into shallow muscles in the skin. Each treatment typically involves 31 injections in seven key areas of the head and neck.

The most common side effect from the Botox shots is a sore neck, and we recommend using an ice pack to reduce the discomfort.

It can take up to six months to see the maximum benefit from Botox. In the meantime, you can continue your regular medications with no risk of a drug interaction




To my new followers, welcome to Smiling Through Tears. This blog is a daily account of my struggle with mental health disorders. To all of my returning followers, thank you for supporting me and following my journey.

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