Botox first received approval from the U.S. Food and Drug Administration in 1989 for use in two rare eye disorders. Approvals for adults and children with upper and lower limb spasticity then came in 2010, 2016, and 2019; spasticity is common in patients with multiple sclerosis, cerebral palsy, and stroke. The medication was cleared for neurogenic detrusor overactivity in adults in 2011 and expanded to children in 2021.
While Botox has not been rigorously studied in pregnant people, data from animal studies suggest that it can cause harm to a developing fetus. Patients on Botox who become pregnant or plan to do so are advised to discuss with their healthcare team the potential benefits and risks of continued treatment.
It is generally recommended that patients who are being treated with Botox avoid drinking alcohol for at least a day or two before and after they receive injections. Alcohol can thin the blood and increase the risk of bruising. Patients are advised to talk with their healthcare team about specific instructions regarding alcohol use and their treatment regimen.
Some participants in clinical trials have seen benefits from Botox treatment in as little as two to six weeks, depending on their specific condition. Trials investigating the therapy for neurogenic detrusor overactivity have reported a significant reduction in episodes of urinary incontinence as early as six weeks. For treatment of spasticity, trials have reported significant differences in muscle tone starting about two weeks after the first injections.
Neither hair loss nor weight gain was reported as a common side effect of Botox in clinical trials. There have been reports of patients who experience alopecia (hair loss) while on Botox, but it is not totally clear whether this effect is attributable to the medication. Patients who experience unexpected reactions after starting a new treatment are advised to discuss such effects with their healthcare team.
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