Wrinkles of Botulinum Toxin

Currently, there are no, or very few, new targets to treat migraine a breakthrough in basic and clinical research is required. Propranolol also combats angina pain and reduces the risk of a heart attack and, once again, it is very cheap. 

Dystonia, rudely translated, means badly functioning muscle tone as is seen in many movement disorders. Cervical dystonia, also known as spasmodic torticollis, is a focal—that is, it occurs in one place—dystonia characterized by neck muscles contracting involuntarily, causing abnormal movements and posture of the head and neck. (Adapted from http //www.dystonia-foundation.org/defined/cervical.asp) 

All clinical pain studies are using a visual-analogue scale. We are so incredibly bad at treating pain. The terribly sad situation with pain is illustrated by the following. To enroll in a study for a new pain drug, a patient has to have pain graded by himself or herself at level 4 or higher on a scale of 1 to 10, where zero is no pain and 10 is unbearable pain. 

Another outcome of the use of Neurontin in the treatment of pain— lower back pain—resulted in the largest fine levied by the FDA of 490 million in 2004 for promoting a drug for an indication for which it was not approved. Physicians are free to prescribe off-label, but companies can only promote or market drugs for indications for which they have conducted successful clinical trials and won FDA approval. 

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