Botox for chronic migraines
In this guide, we review the aspects of Botox for chronic migraines, how to get botox for migraines covered by insurance, botox injections for chronic migraines, and where they inject Botox for migraines.
Botox (botulinum toxin type A) is a type of nerve toxin that paralyzes muscles. It comes from a bacterium known as Clostridium botulinum. People with chronic migraines found it effective when used for cosmetic treatment. People who received Botox reported fewer headaches.
When is Botox used?
Botox is approved for use on the NHS for the treatment of chronic migraine in adults. Chronic migraine is defined as having at least 15 headache days a month, with at least eight of those featuring migraine symptoms.
It is not an effective treatment for other types of headache, including episodic migraine (headache for fewer than 15 days a month), tension-type headache, and cluster headache.
Botulinum toxin is used to treat other conditions, such as hemifacial spasms, cervical dystonia, cerebral palsy, bladder pain, lower back pain, neuropathic pain, and stroke.
In England and Wales, the National Institute of Health and Care Excellence (NICE) recommends the use of Botox for people with chronic migraine who:
- have failed at least three preventive treatments
- have been appropriately managed for medication overuse headache
In Scotland, the Scottish Medicines Consortium (SMC) approved Botox for chronic migraine where people have failed to respond to three oral preventive treatments and any medication overuse has been appropriately managed.
In Northern Ireland, the Department of Health endorsed the NICE appraisal approving Botox for chronic migraine in 2012.
Botox for chronic migraines
BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected into muscles and used to prevent headaches in adults with chronic migraine who have 15 or more days each month with headaches lasting 4 or more hours each day in people 18 years and older.
It is not known whether BOTOX is safe and effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).
IMPORTANT SAFETY INFORMATION
BOTOX may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX:
- Problems swallowing, speaking, or breathingbecause of weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are preexisting before injection. Swallowing problems may last for several months.
- Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms, including loss of strength and all-over muscle weakness; double vision; blurred vision; drooping eyelids; hoarseness , change or loss of voice; trouble saying words clearly; loss of bladder control; trouble breathing; and difficulty swallowing.
There has not been a confirmed serious case of spreading the toxin effect away from the injection site when BOTOX has been used at the recommended dose to treat chronic migraine.
BOTOX may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of receiving BOTOX. If this happens, do not drive a car, operate machinery, or do other dangerous activities.
how to get botox for migraines covered by insurance
If you’re one of the million Americans who suffer from migraines, you know how debilitating they can be. The American Migraine Foundation reports that migraine affects over 37 million men, women, and children in the United States.
One of the best ways to find relief is through Botox injections. However, you may be wondering, does insurance cover Botox for migraines?
How Does Botox Work?
Experts believe that overactive nerves cause migraines. Botox works by temporarily paralyzing the muscles that these nerves supply. It decreases migraine frequency by preventing migraines before they start.
Botox blocks the release of a chemical called acetylcholine. This chemical is responsible for sending signals between nerve cells. By blocking the release of this chemical, botox can help to reduce or even eliminate migraine headaches.
Botox injections are usually given every 12 weeks. The number of injections and the location will depend on the severity of your migraines.
Insurance Coverage For Botox Injections
Most insurance companies will cover at least a portion of the cost of botox injections for migraines. However, coverage may vary depending on your plan. It’s essential to check with your insurance provider to see what is covered under your plan.
Some of the eligibility criteria that insurance companies use to determine coverage for botox injections include:
1) Number of Migraines: You must have a certain number of migraines per month to be eligible for coverage. This number varies depending on the insurance company, but it is typically between eight and twelve migraines per month.
2) Previous Treatment: You may be required to try other treatments for migraines before your insurance company covers botox injections. In some cases, your insurance company may only cover a portion of the cost of botox injections. In this case, you may be responsible for paying the remaining balance out-of-pocket.
3) Patient is Diagnosed With Chronic Headaches: Some insurance companies will only cover botox injections if you have been diagnosed with chronic headaches by a doctor.
4) Persistent Headaches Despite Taking Medication: If If you are taking medication for your migraines but are still experiencing a high number of headaches, you may be eligible for coverage.
These medicines include
a) Anti-seizure medications
b) Antidepressants
c) Beta-blockers
d) Calcium channel blockers
e) Tricyclic antidepressants
For instance, people sometimes use antidepressants like amitriptline and nortriptyline to prevent migraines. If you have tried these drugs and still have pain, you may qualify for Medicaid Botox coverage.
botox injections for chronic migraines
Botox is useful to treat and prevent migraine. The full name is Botulinum toxin A.
It is also used to treat a range of conditions such as dystonia, excessive sweating, an overactive bladder, and is used cosmetically.
It is given by injection into specific areas where it causes those muscles to relax but also connects with the nerves in those muscles to help reduce pain.
Any benefits and side effects of Botox are temporary and will wear off completely by 12 weeks. If it is effective, you can usually have it again at 12 weeks.
Who is it for?
Botox is licensed and approved in the UK for people with chronic migraine (at least 15 days of headache a month, eight of which are migraine). Your neurologist or headache specialist will offer this treatment if you have already tried three migraine preventive treatments without them helping to improve your migraine. They will also want to check that you are not using painkillers and triptans too frequently.
What to expect at the clinic
You should bring along your headache diary to the clinic appointment. You should record how many days you have migraines and headaches, as well as the number of days (not doses) you use a pain relief treatment.
Many people are understandably anxious about having the 31 injections on their heads, necks, and shoulders. However, most are surprised at how well they tolerate these minimal, superficial injections. A very fine needle places the injections in the forehead, temple area, back of the head, upper neck, and shoulders.
The actual injections can be done in 10-15 minutes. However, before the procedure is done, your nurse or doctor will take some time to look at your headache diary, discuss your headache pattern, explain the procedure (including potential benefits and side effects) and give you time to ask questions.
For most people, the injections are done while you are sitting (but you can lie down if preferred or if you feel faint). The injections might be uncomfortable and sting for a few seconds, but this settles quickly.
It is best to come without make-up but the skin will be cleaned prior to the injections, to reduce the chances of infection.
Botox for Chronic Migraine Overview
Botox, or onabotulinum toxin A, is a drug made from the bacteria Clostridium botulinum. It is known to reduce and smooth facial wrinkles, but it can also prevent chronic migraines. Researchers began exploring Botox for migraines after people who received it for cosmetic purposes reported an improvement in their migraine symptoms. Initially, researchers designed trials to evaluate its efficacy in treating episodic migraine, but those studies failed to demonstrate a significant benefit. Botox was subsequently studied in patients with chronic migraine diagnoses and found to be effective.
Onabotulinum toxin A has been the subject of two large studies evaluating its effectiveness and safety. These studies found that Botox significantly reduces the number of headache and migraine days in patients with chronic migraine (defined as having more than 15 headache days per month, with at least eight of them being migraines). These findings led to the approval of Botox injections by the U.S. Food and Drug Administration (FDA) for the treatment of chronic migraine.
Am I a suitable candidate for Botox for chronic migraine?
You may be a good candidate for Botox injections if you are an adult suffering from chronic migraine. Botox is not FDA approved for people with migraine who have 14 or fewer headache days per month.
Because Botox can cause serious side effects, it is important to tell your doctor about any other medical conditions you have and any medications you take. You may be at higher risk for serious side effects, such as difficulty swallowing or breathing, if you have neuromuscular conditions such as amyotrophic lateral sclerosis (ALS), myasthenia gravis, or Lambert-Eaton syndrome.
You should not receive Botox injections if you have had an arimabotulinumtoxinBany botulinabobotulinumtoxinA
- bloc®rimabotulinumtoxinB)
- Dysport®(abobotulinumtoxinA)
- Xeomin®(incobotulinumtoxinA)
Conclusion
Botox has been approved by the U.S. Food and Drug Administration (FDA) as a preventative treatment for chronic migraine, which is characterized by headaches that occur at least 15 days per month and last four hours or more. Insurance companies usually require people to try at least two other “first-line” preventative medications before they will authorize and approve Botox for chronic migraine.
The mechanism by which Botox works to treat migraine is complex. It is thought to function by reducing the release of inflammatory and excitatory neurotransmitters and proteins.
Neurotransmitters are chemicals that the nervous system uses to transmit signals between nerve cells, which are also called neurons. Proteins are large biological molecules that perform important structural, functional, and regulatory functions in your cells.
Calcitonin gene-related peptide, or CGRP, is one of these protein neurotransmitters that migraine sufferers may have elevated levels of.
Sensory nerve endings are considered overactive in patients with migraines. Botox helps prevent pain signals from being sent to the brain by the peripheral nerves and is also thought to reduce the activity of CGRP.
