With Botox, however, the dose makes the poison. Botox works by temporarily immobilizing muscle activity. It does this by blocking nerve-muscle communication, which makes the injected muscles unable to contract. Mitchell Brin, senior vice president of drug development at Allergan and chief scientific officer for Botox. The effects of Botox can last about three to six months depending on the condition.
The use of Botox for migraines was, like many other new applications for the drug, a kind of happy accident. A Beverly Hills plastic surgeon observed that people who got Botox for wrinkles were reporting fewer headaches, paving the way for studies about migraines. Similarly, doctors in Europe were intrigued when they noticed that their patients who got Botox for facial spasms were sweating less than usual. Though people often associate pharmaceutical discovery with giant industrial laboratories and expansive, rigorous clinical trials, the mission creep for Botox—as with many other drugs that have received government approval for one specific use—has been driven by off-label use.
Linda Brubaker, dean and chief diversity officer of the Loyola University Chicago Stritch School of Medicine, who independently studied Botox for overactive bladder before the FDA approved it for that condition in That rep may share that with another of his clients, and so on. The company acknowledged that its marketing of Botox led to off-label uses of the drug. With Botox, this includes effects spreading from the injection site to other parts of the body, causing muscle weakness, double vision and drooping eyelids.
Ray Chester, an attorney in Austin who has represented several plaintiffs in lawsuits against Allergan, says that just about all the cases he has handled involved off-label use of the drug. Allergan, which initially planned to appeal, ended up privately settling the case with the family, and the terms of the settlement have been kept confidential.
Though the off-label use of drugs makes many experts—including some at the FDA—uncomfortable, the practice is de rigueur in medicine. Now Allergan hopes to replicate the findings on a larger scale, and the company is currently running its own Phase 2 clinical trial.
In some cases, how Botox works is evident: the toxin can block the signals between nerves and muscles, which is why it can help calm an overactive bladder, say, or a twitching eye, or the facial muscles that make wrinkles more apparent. In other cases, however with migraines as well as with depression , scientists are flummoxed. But it could be something else altogether. He also injected Botox into one side of the brain in mice and found that it spread to the opposite side.
That suggested the toxin could access the nervous system and the brain. But in August , Chapman and his graduate student Ewa Bomba-Warczak published a study in the journal Cell Reports showing similar spreading effects in animal cells in the lab. Chapman and Bomba-Warczak both think Botox is safe when used correctly, but they say their inboxes quickly filled with messages after their study was published.
The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing.
For more information refer to the Medication Guide or talk with your doctor. To report a side effect, please call Allergan at This website uses cookies and other technologies to personalize content and to show you more personalized ads for example, Google Ads and Facebook on this and other websites, as well as provide you with social media features on this website such as, Facebook, Twitter, LinkedIn.
Read Less. They found strabismus was successfully corrected in two-thirds of patients tested. Scott said those results are encouraging and will replace surgery for many patients. Studies in children with strabismus to get just the right dose of bupivacaine and to see long-term effects are just getting under way. Bupivacaine can stimulate eye muscles in a manner that he compares to lifting weights. In addition to strabismus, Botox has been a godsend to sufferers of benign essential blepharospasm, a neurological condition in which the eyes involuntarily force themselves shut, by stopping the muscles from going into spasm.
Blepharospasm affects an estimated 20, to 50, Americans; for some unknown reasons, women are twice as likely to suffer from it as men. Scott remembered how the first blepharospasm patient he treated in had her eyes so tightly clamped that her husband had to guide her into his office. He injected Botox into the center of her eyelid and was ecstatic to find the next day that the eyelid was wide open — only to discover the day after that that it had re-drooped.
That experience taught him to keep the upper eyelid doses at the margins and to the sides of the eyelids and to keep the doses low. These days, Scott is developing a method of treating sufferers of blepharospasm with tiny implanted devices that perform pacemaker-like stimulation of the eyelid muscles to hold the eyes open. The views expressed are those of the author s and are not necessarily those of Scientific American. Already a subscriber? Sign in.
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