I'm currently receiving Botox for migraines, I had my second treatment on New Years Eve. The first treatment made them much worse, but they also tried to withdraw the topamax that I've been currently taking to keep them under control at the same time. From what I understand, it takes about a year of being on the Botox to reach optimum benefit... They gave me back the topamax and now they are back under control, pretty much. I also have Lupus SLE, idk if that impacts anything. I keep a daily migraine diary and I look forward to titrating down off of the topamax as I continue on with the Botox and keep my fingers crossed.