Botox can be a life-changing treatment for people with chronic migraine. Others try it once or twice and give up, believing it is ineffective for them. If you're in the latter category, you might want to consider it again—it can take three consecutive rounds of Botox to notice an improvement in migraine symptoms, according to recent research.

In a study of 688 people with chronic migraine, about half had reductions in the number of headache/migraine days, reduction in the number of headache/migraine hours, and total score on a quality of life assessment (called Headache Impact Test) after the first round of injections, but others didn’t have improvement until after the second or third set of injections.

Number of headache/migraine days reduced by at least 50%:

• Round one: 49.3%
• Round two: an additional 11.3%
• Round three: an additional 10.3%

Number of hours with headache/migraine reduced by at least 50%:

• Round one: 54.2%
• Round two: an additional 11.6%
• Round three: an additional 7.4%

Headache Impact Test score reduced by five or more points:

• Round one: 56.3%
• Round two: an additional 14.5%
• Round three: an additional 7.7%

Before your first set of Botox injections, ask your doctor about how many rounds of injections they do before deciding Botox is ineffective and what the injection schedule is. It’s important to get the injections consecutively so that the effects can build accumulate.

Reference:

• Silberstein, S. D., Dodick, D. W., Aurora, S. K., Diener, H. C., DeGryse, R. E., Lipton, R. B., & Turkel, C. C. (2014). Per cent of patients with chronic migraine who responded per onabotulinumtoxin-A treatment cycle: PREEMPT. Journal of Neurology, Neurosurgery & Psychiatry, jnnp-2013.