Tuesday, December 19, 2006

Botox is gaining respect as medication

Special to Newsday

December 19, 2006

Botox may have risen to fame on its ability to freeze frown lines and make wrinkles temporarily disappear.

But when used properly by trained professionals, doctors say, botulinum toxin - sold under several brand names including Botox, MyBloc, Dysport and NeuroBlock - can be a versatile therapy for a range of medical conditions.

It is not always the first treatment of choice for these conditions, according to medical reports, but it can be surprisingly effective, say doctors familiar with it, and might someday have even broader uses.

"People who don't know anything about it have this impression of what Botox is," says Dr. Anthony Geraci, a neurologist at Lutheran Medical Center in Brooklyn, who is studying Botox in stroke patients. "It's received a bad rap. The reality is that it's an incredible medicinal."

Years before receiving FDA approval to smooth facial lines, Botox had already been approved to treat crossed eyes and uncontrollable eye blinking. It's also approved for head and neck pain associated with an involuntary movement disorder known as dystonia.

Two years after it gained fame as a wrinkle reducer, Botox received FDA approval for the treatment of excessive underarm sweating. Today, studies are under way to evaluate its ability to reduce headache and chronic migraine pain, alleviate muscle stiffness and control overactive bladders.

It also has been studied in patients with tennis elbow and tinnitus, or ringing in the ears, although initial reports say more evidence is needed to prove its effectiveness for those conditions.

"Botox works by temporarily relaxing muscles, and by blocking the release of certain substances that cause pain," says Dr. Robert Duarte, director of the Long Island Jewish Pain and Headache Center in Manhasset. Aside from possible injection discomfort, there are few to no reported side effects, he said.

"I've been working with Botox for 10 years," says Geraci, who uses it to treat patients who have stiffness from stroke, spinal cord diseases, traumatic brain injury and multiple sclerosis. "I became interested in it because of its ability to relax muscles in a very targeted fashion. One of the big problems we have when we treat patients is that all the medications made them sleepy and have other bad side effects. I can put this medication into the muscles and affect relaxation without any systemic side effects. It's really safe."

Sharon Roth, 48, of Roslyn Heights has been receiving Botox injections to fight her chronic, daily migraines for the past three years, about four times a year. "I tried every medication on the market for migraines, and nothing worked."

Once she started receiving injections in her forehead, temple and neck, she felt different almost immediately. "At first it feels like you have duct tape on your head. Then I feel relief. My migraines are less severe, and I don't have to take my medication as much. I went from being incapacitated in bed in a dark room to being able to function while still having pain."

Nevertheless, Duarte cautioned that patients considering Botox should consult a specialist in their condition. And insurance may cover only an FDA-approved use of the drug.