HeadWise OnabotulinumtoxinA for Migraine: What You Need to Know
Jul 9, 2025
Fred Cohen, an assistant professor at the Icahn School of Medicine and founder of Headache Intervention, delves into the surprising benefits of OnabotulinumtoxinA for chronic migraines. He explains how Botox works beyond just muscle relaxation and discusses its effectiveness based on research and real-world data. The conversation highlights customized treatment protocols and whether Botox can be combined with CGRP monoclonal antibodies. Additionally, Cohen addresses common concerns about appearance, side effects, and insurance, making it a must-listen for anyone considering Botox for migraines.
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Botox's Migraine Mechanism
- OnabotulinumtoxinA (Botox) works for chronic migraine by blocking pain signals, not just muscle relaxation.
- It inhibits release of substances like CGRP and substance P involved in migraine pain.
Botox Effectiveness for Chronic Migraine
- Botox is effective for chronic migraine, defined as 15 or more headache days a month with 8 migraines.
- It reduces monthly headache days by about 8 to 10 days on average.
Cohen’s Research Uncovers Combo Benefits
- Fred Cohen’s early research showed combining Botox and CGRP monoclonal antibodies significantly reduces migraine days.
- He helped gain insurance approval for dual treatment despite initial pushback.