OnabotulinumtoxinA (BOTOX) was shown to have better results with chronic migraine people who (in recent study published in the European Journal of Neurology):
- Have unilateral pain vs bilateral pain.
- Fewer disabilities days per month
- Milder headache
- Started 12 months of symptom onset
So, not, not, not, not me I guess.
The study involved 725 subjects with chronic migraine. Those that had failed greater than 2 preventative treatments. They received it every 12 weeks for a year. They recorded intensity, quantity, and duration in a diary that was collected at 3 months and then again at 12 months.
In 79.3 subjects pain was reduced by 50% after a year. Migraines, analgesics, ER visits, headache intensity and sick days all reduced as well.
When compared to non-responders the factors
When onabotulinumtoxinA responders (n=575) were compared with nonresponders (n=150), the following factors were associated with response to onabotulinumtoxinA: unilateral pain (P =.02), fewer disability days per month at baseline (P =.001), lower headache intensity at baseline (P =.02), and initiation of treatment within 12 months of chronic migraine onset (P =.045). Most patients (94.9%) reported no adverse events at 12-month follow-up. Clinical Pain Advisor
So this doesn’t bode well for my 3rd round which I was hoping might be the one that works, eh? But we shall see. You never know. A minor reduction would still be a reduction.
Domínguez C, Pozo-Rosich P, Torres-Ferrús M. OnabotuliumtoxinA in chronic migraine: predictors of response. A prospective multicentre descriptive study