Botox to be the new treatment for chronic migraine
By Jeremy Laurance The Independent Friday 11th May 2012
Botox, the anti wrinkle treatment based on the lethal paralysing drug botulinum toxin, is expected to be recommended for the treatment of chronic migraine on the health service next month by the NHS drugs watchdog. Migraines affect an estimated 6 Million people in Britain – 15 % of the adult population, but only a small portion who have headaches on at least 15 days a month, 8 of which are migraines, will qualify for the treatment. The drug works by paralysing tiny muscles in the head and neck when injected under the skin. The effect is to smooth out frown lines and wrinkles but has also been to ease the pain of chronic migraine sufferers. In a draft of its final guidance to the NHS, The National Institute for Health and Clinical Excellence recommends the treatments for sufferers who have already tried three preventative drugs without success. If no appeals are received against its guidance, NICE expects to issue it to the NHS in June. Primary care trusts have three months to allocate funds for the drug. An estimated 1.6 % of the population suffer from chronic migraines which can be extremely debilitating, preventing sufferers from leading a normal life. Migraines affect the young more than the old and are more common in women. They are caused by an “over sensitive” brain which reacts to triggers such as fatigue, hunger, stress or the weather. Migraines impose a huge drain on the economy as a result of sickness absence. Dr Fayyaz Ahmed, Chair of the British Association for the study of Headache, said: “The headache experts with firsthand experience in treating chronic migraine know how debilitating the condition can be for some patients, and Botox can be a life changing treatment”. Botox, made by Allergan, was licensed as a treatment for chronic migraine in 2010. It is given as tiny injections under the skin in between 31 and 39 sites around the head and neck. One course costs £350 and courses can be repeated every three months.
Gerry Gajadharsingh writes:
This means that switching off the muscles of the neck and scalp can reduce the frequency of some Migraine sufferers but it is not a cure. If it needs to be repeated every 3 months the overall cost seems very high. Perhaps exploring why the patient is sensitive and why those muscles tighten up may be worth exploring. Osteopathic techniques can be very beneficial for those patients where the mechanical and muscular components of the Migraine are the most important. Breathing re-education to down regulate an over active sympathetic nervous system (stress response) may also be very helpful. Making sure patients adequately hydrate can minimise the impact of the dehydration component of the Migraine. Balanced glucose regulation via intake of low gylcaemic load carbohydrates may also be helpful. In women there is often a hormonal component pre-menstrually where Oestrogen and Progesterone levels drop. All in all one of the most complex clinical problems and it can take time and effort to find out what is the most appropriate treatment for individual patients.