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The drug BOTOX®, which is widely known as a treatment for
wrinkles, is now being used by some doctors as a treatment
for migraine headaches.
 Various
small studies have found favorable results for the treatment,
with some reporting success rates as high as 90 percent, however
only one large, double-blind study has been conducted so far.
In that study, results were confusing, indicating that a
low dose of the drug was beneficial while a higher dose was
not.
BOTOX® manufacturer Allergan is sponsoring some major double-blind
clinical trials that will be finished in about two years.
Experts are not certain why the muscle-paralyzing effects
of BOTOX® would be useful for headaches, and some suspect a
placebo effect may be occurring. Supporters of the drug say
that is may work by interrupting pain pathways.
Since BOTOX® is not FDA-approved for the treatment of migraines,
insurance companies are not likely to cover the procedure,
which can cost between $600 and $900 every three months. Just
one vial of BOTOX® costs from $400 to $500.
Doctors can use BOTOX® to treat migraines through a common
practice known as "off-label" use. Since BOTOX® is
FDA-approved for some conditions, including wrinkles, doctors
can use it to treat other disorders at their own discretion.
Critics of BOTOX® say that patients should be wary of the
drug because so much money is at stake. According to one study,
migraines
cost the United States $18 billion a year in drugs, emergency
room visits and lost work time.
However, doctors make more money from BOTOX® than other migraine
drugs and many are paid by the drug’s manufacturer to
teach the procedure to other doctors.
The
Seattle Times April 23, 2003
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