Effects of onabotulinumtoxinA treatment on efficacy, depression, anxiety, and disability in Turkish patients with chronic migraine

Abstract

Chronic migraine causes a serious labour loss and disability in the society and increases the risk of depression and anxiety by negatively affecting the quality of life. The purpose of this study was to investigate the effects of onabotulinumtoxinA (BoNT-A) treatment on efficacy before and after treatment in our cases with chronic migraine as well as on depression, anxiety and disability caused by migraine. According to the International Headache Classification (ICHD-III beta version), 60 adult patients who were diagnosed with chronic migraine were included in the study. A total of 155 IU BoNT-A treatment from 31 regions was administered in accordance with the protocol of PREEMPT study. Information about the characteristics of patients' headaches, background and family history, drugs they used was recorded. At the baseline and in the first and third month after the BoNT-A injection, VAS scores, the number of both headache days and attacks, the headache duration, the frequency of application to emergency services and the intake of both analgesics and triptans during attacks were evaluated. MIDAS, BDI and BAI were evaluated at the baseline and in the third month after the BoNT-A injection. BoNT-A injection provided a significant decrease in the number of days and severity of headaches, MIDAS disability scores and psychiatric complaints in cases with chronic migraine who did not respond to prophylactic treatments in the third month of the treatment.

OnabotulinumtoxinA effectiveness on chronic migraine, negative emotional states and sleep quality: a single-center prospective cohort study

“…In terms of monthly headache frequency, headache severity, number of analgesics used and MIDAS scores our findings support the association of OnabotA therapy with rapid improvement in migraine parameters usually after the first session as reported in past studies [26, 27, 30, 51–53]. …”

Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial

“…The rationale for the exclusion of botox, nerve blocks, and IV infusion was to ensure there would be enough attacks during the run‐in phase of the study. Due to the temporal pattern of botox treatment, in which the positive effect of the treatment shows a tendency to wane between the first and third months after the treatment, we specifically excluded those who used botox 1 month prior to enrollment.…”

Withdrawal failure in patients with chronic migraine and medication overuse headache

“…So the improvement in anxiety and depression symptoms may either be an effect of drugs specifically targeting these symptoms, or be an effect of improvement in headache outcome, and a different study design would be needed to approach such a relation. Anyway, addressing symptoms of anxiety and depression may be one of the keys to success, as shown in studies who specifically address it in the treatment of CM with onabotulinumtoxin‐A 50,51 . In particular, the study of Blumenfeld and colleagues 51 showed that a considerable part of subjects who showed relevant depression and anxiety at baseline significantly improved over the 108 weeks of the study (respectively, 78% of those with relevant depression and 82% of those with relevant anxiety).…”

“…Anyway, addressing symptoms of anxiety and depression may be one of the keys to success, as shown in studies who specifically address it in the treatment of CM with onabotulinumtoxin‐A. 50 , 51 In particular, the study of Blumenfeld and colleagues 51 showed that a considerable part of subjects who showed relevant depression and anxiety at baseline significantly improved over the 108 weeks of the study (respectively, 78% of those with relevant depression and 82% of those with relevant anxiety). However, the vast majority of these patients improved by 12 weeks (respectively, 62% of those with relevant depression and 69% of those with relevant anxiety).…”