Powered By
Starting a migraine treatment can bring hope, questions, and frustration. That is especially true when attacks are frequent, severe, or hard to control.
Botox (onabotulinumtoxinA) is approved by the U.S. Food and Drug Administration (FDA) to prevent headaches in adults with chronic migraine. Chronic migraine means having headaches on 15 or more days per month for more than three months, with at least eight days per month having migraine features or responding to migraine-specific treatment.
Botox is a preventive treatment, not a medicine meant to stop an attack once it starts. It isn’t approved for episodic migraine, which means 14 or fewer headache days per month.
On MyMigraineTeam, members describe a wide range of experiences. Some say Botox lowered the number or intensity of migraine headaches. Others say it helped only partly, wore off early, or did not help enough.
For more on Botox, including how to take it, side effects, and advice from other members, check out this treatment article. ❯
Here are six questions MyMigraineTeam members have raised about life on Botox.
A practical way to think about results is whether the number of headache days is going down over time. In the chronic migraine studies, outcomes were evaluated over 24 weeks, with injections every 12 weeks. At week 24, headache days decreased by 7.8 days from baseline with Botox versus 6.4 days with a placebo (inactive treatment) in one study and by 9.2 days versus 6.9 days in the second.
One member described a major drop: “I have started Botox injections with great results. Down from 15-plus migraines a month to one!!!!”
Not everyone sees enough benefit: “I tried Botox for three years. It never did anything for me and I stopped those treatments.”
These are individual experiences. They don’t establish how much or how quickly Botox will reduce migraine attacks. Members’ stories show that “working” can mean fewer headache days, less intense attacks, or better function. Tracking headache days, severity, and rescue-medication use can help you and your neurologist discuss whether Botox is helping.
Botox doesn’t work immediately, and the time it takes to notice improvement can vary. In clinical studies, some people experienced fewer headache days within the first four weeks of treatment. Others needed additional rounds of injections to see meaningful results.
Some members noticed improvement quickly: “It’s been a little over a week, and I have already had three no-pain days, and the rest are pretty mild pain days.”
Others described a slower start: “The first treatment was difficult because it took about six weeks to kick in.”
These experiences vary, so one person’s timeline is not a benchmark for another’s. Keep a record of injection dates and headache patterns to review with your care team.
For chronic migraine, the labeled dose is 155 units divided across 31 injection sites in seven head and neck muscle areas. The recommended retreatment schedule is every 12 weeks.
Many members focused on the visit itself. One shared, “They aren’t pleasant, but it goes very quickly because each injection seems to go just beneath the skin and the amount is barely a drop.”
For some, the procedure feels harder when a migraine is active: “Yesterday was Botox Shots Day for me, all 31 of them in one sitting, and yes, the procedure hurts when you have a migraine going into your appointment.”
The labeled schedule is every 12 weeks, even though some members say relief fades sooner.
In chronic migraine trials, common adverse reactions reported more often with Botox than placebo included neck pain and headache. Other reported reactions included:
The prescribing information also carries a boxed warning that botulinum toxin effects may spread beyond the injection site. Possible symptoms include generalized weakness, double vision, drooping eyelids, trouble speaking, trouble swallowing, or breathing difficulties.
One member wrote, “I get neck pain and migraine after every Botox treatment.”
Another shared, “I had to stop my Botox injections because I had experienced a left droopy eye.”
Having a symptom while on Botox doesn’t necessarily mean the medication caused it. Still, new, severe, or worsening symptoms are worth bringing up with your healthcare provider right away. Seek immediate medical help for trouble swallowing, speaking, or breathing after treatment.
Botox is one preventive treatment option for chronic migraine. The medication’s prescribing information warns that certain medications may interact with Botox and increase the risk of muscle weakness or related side effects. These include:
Some members said Botox was added because other options were not enough. One wrote, “I take Qulipta daily, Botox every few months since 2024, and I have Zolmitriptan as well as Ubrelvy for acute medication.”
Some people stop Botox injections because the benefit may be limited or fades. “I can’t say it did much for me, and when I balanced out putting more drugs into my body against the minimal relief I was getting from the Botox, I decided to stop,” said one MyMigraineTeam member.
If you are thinking about adding, continuing, or stopping Botox, bring your symptom notes, side effects, and medication list to your doctor’s appointment. Don’t change treatment on your own.
Insurance coverage and out-of-pocket costs for Botox can vary from person to person. The manufacturer’s Botox Complete Savings Program may help eligible people with commercial insurance pay for treatment costs not covered by their insurance, including copays, coinsurance, and deductibles. People with government-funded insurance, such as Medicare or Medicaid, aren’t eligible for this savings program.
For people with limited or no insurance coverage who meet certain financial requirements, AbbVie also offers myAbbVie Assist, which may provide Botox at no cost. Eligibility requirements and restrictions apply.
For some MyMigraineTeam members, getting insurance approval for Botox was a challenge. One member described the process: “I had to appeal to my insurance with my neurologist for final approval. I’m glad I got it!”
Others reported significant treatment costs. One member shared, “I still have to pay $1,700.00 out of pocket for each treatment.”
What you pay for Botox can depend on your insurance coverage and other factors, so another member’s costs may not reflect your own. If you’re having trouble getting or affording Botox, let your healthcare team know. Your neurologist’s office may be able to help you understand insurance requirements, navigate prior authorization (approval required by your insurer before treatment), appeal a denial, or explore financial assistance options.
Living with chronic migraine can involve paying attention to more than just the number of headache days you have. The severity of migraine attacks, treatment side effects, and how well your treatment plan fits into your everyday life also matter when evaluating whether it’s working for you.
The experiences shared on MyMigraineTeam show how differently people can respond to treatment. Keeping track of your headache days, migraine symptoms, side effects, and questions can help you and your healthcare team have more productive conversations about your migraine care and treatment options.
Share your own experience or a question you still have about treatment.
Continue with Facebook
Continue with Email
You'll also get the latest articles directly to your inbox.
You'll also get the latest articles directly to your inbox.
Get updates directly to your inbox.
Continue with Facebook
Continue with Email
Continue with Facebook
Continue with Email
Become a member to get even more
Join
Your Privacy Choices
