Botox 'cures migraines too'

Botox can fix your wrinkles - and now also your migraines.

South African doctors are using botox (botulinum toxin type A) for the relief of chronic migraine, though it has not been registered for that use in this country.

Spokesman for the Association of Plastic and Reconstructive Surgeons, Dr Chris Snijman, explained how botox helps migraine sufferers: "If you paralyse the specific muscle group, you will decrease tension on the nerve and this can abort the initiation of a migraine.

"I have had quite a few patients who comment on decreased headaches after using botox."

Yesterday, Allergan Pharmaceuticals, the company that imports and distributes botox treatments in South Africa, said it will soon ask the Medicines Control Council to approve the use of botox for the relief of chronic migraine.

Johannesburg general practitioner Margaret Vockema said "the odd patient" who asks for botox for migraines is willing to pay more than R3000 for 100 units of the substance for "about six months" of relief.

Vockema said she injects the botox between the eyebrows and onto the scalp in parallel lines from the top of the forehead to the base of the neck.

"The patients I have treated have had good relief," she said.

Allergan spokesman Gené van den Ende said her company "could not promote it [for migraine prevention]" in this country because migraine was not an approved indication for use of the drug. However, doctors could use botox "off-label".

"As long as they inform their patients that the indication is off-label, it is okay," she said.

Between 2000 and 2005, Allergan sales representatives in the US unlawfully promoted botox for migraine relief. The company was taken to court and last year pleaded guilty to a charge of misbranding. It paid the US government a $375-million settlement.

But a 2010 clinical trial of 1384 adults with a history of migraine found that botox injections made a difference.

The first country to approve botox for migraine was the UK.

The US Food and Drugs Administration approved the use of botox for migraine prevention in October.

Though the market for botox in South Africa is small compared to the UK and US, Van den Ende hopes that the Medicines Control Council will approve it.

"I think there's a good chance we'll get it," she said.