Surprising Botox Adverse Effects

I wanted to share just a few of the most surprising adverse effects I've uncovered while reading through the package inserts for all botulinum toxin (BoNT) products. Patients who receive BoNT for therapeutic purposes are the ones who are most at risk of developing botulism symptoms, with these symptoms occurring in as little as 1 to 15% or more of clinical trial patients.

I will list the adverse effects and how often they occurred in the treatment group as well as the placebo group, so you can get a sense of what the actual risk of each symptom might be.

It's important to note that the adverse effects listed on the package inserts are somewhat different based on the injection location and unit amount. As you read through each of the symptoms, I want you to pay close attention to the site of injection (which will be underlined) and the site of the adverse effect.

All of the symptoms below indicate "toxin spread", or, put less appealingly: botulism.

Manufacturers are NOT required to report on how long these symptoms can last. Research on both foodborne and iatrogenic botulism has reported that botulism symptoms can last for months or years, depending on the severity of the disease.

Botox Therapeutic

(Numbers in parentheses indicate placebo group for comparison)

Pediatric limb spasticity

Seizures: 5% (0%)

Nausea: 4% (0%)

Decreased appetite: 2% (0%) - This was a botulism symptom I had during my illness. I lost 20 pounds in 2 months without a single hunger pain.

Adult limb spasticity

Fatigue: 2-3% (0%)

Chronic Migraines

Muscle weakness: 4% (0%)

Bladder dysfunction

UTI: 18% (6%)

Need for cathetizeration due to urinary retention: 6.5% (.4%)

Xeomin

(Numbers in parentheses indicate placebo group for comparison)

Chronic sialorrhea (hypersalivation)

Tooth extraction: 4% (0%)

Dysphonia: 3% (0%)

Back pain: 3% (0%)

Dry eye: 3% (0%)

Upper limb spasticity

Seizures: 3% (0%)

Cervical dystonia (neck spasms)

Dysphagia: 13-18% (3%)

Nervous system disorder: 16-17% (7%)

Gastrointestinal disorders: 18-24% (4%)

Blepharospasm (eye spasms)

Dry mouth: 16% (3%)

Diarrhea: 8% (0%)

Nervous system disorders: 14% (9%)

Glabellar lines (frown lines)

Eye disorder: .9% (0%)

Dysport

(Numbers in parentheses indicate placebo group for comparison)

Cervical dystonia

Dysphonia: 18-28% (0%)

Eye disorders: 6-17% (0%)

(these eye disorders after Dysport injections into the NECK included: vision blurred, double vision, visual acuity reduced, eye pain, eyelid disorder, accommodation disorder, dry eye, eye pruritus.

Glabellar lines

Blood present in the urine: 2% (0%)

Upper limb spasticity

Blood triglycerides increased: 3% (0%)

Depression: 2-3% (1%)

Lower limb spasticity

Diarrhea: 2-4% (0%)