Answers to Common Headache Questions

Premier Health providers answer frequently asked questions about headaches.

What are your thoughts on alternative treatments to migraines, such as Botox?

Dr. Richard Kim discusses alternative treatments for migraine, such as Botox. Click play to watch the video or read the transcript.

What are your thoughts on alternative treatments to migraines, such as Botox?

Botox is actually the only FDA-approved medication for the treatment of chronic migraine. Chronic migraine per the FDA definition is having a history of migraine with headaches 15 or more days a month, lasting four hours at a time. I do consider it to be the first line medication and treatment for chronic migraine, but the limiting factor is insurance companies and their coverage for Botox. Insurance companies typically require the patient to try and fail two or three different classes of preventative medications for migraine before they will approve the Botox. Botox, in my opinion, has fewer side effects compared to oral preventative medications, and I think is well tolerated.

Botox is given in a series of 31 injection every twelve weeks. The sites are across the upper and lower forehead, the sides of the head, the back of the head, the upper neck, and in the shoulders.

   

Botox is the only FDA-approved medicine for the treatment of chronic migraine. As defined by the FDA, chronic migraine is when you have a history of migraine with headaches 15 or more days a month, lasting four hours at a time. I do consider Botox to be the first line treatment for chronic migraine, but the limiting factor is insurance coverage for Botox. Insurance companies typically require a patient to try and fail two or three different classes of preventive medicines for migraine before they will approve Botox. Botox, in my opinion, has fewer side effects compared to oral preventive medications, and it is well tolerated.

Botox is given every 12 weeks in a series of 31 injections. The injection sites are across the upper and lower forehead, the sides of the head, the back of the head, the upper neck and in the shoulders.

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Source: Richard Kim, MD, The Clinical Neuroscience Institute; Aaron Block, MD, Franklin Family Practice

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