Dr. Alexander Mauskop

It could be the barrels, the different oak, different tannins and different things.

Or maybe you're just on vacation and relaxed.

But people often tell me that when I go to Europe, have wine in Italy or France, no headache.

I come here, a good bottle of wine, still get a headache.

Well, it's not the same, actually.

On the label on the back of each bottle, as you know, there's a warning.

Added sulfites for preservatives.

There's a preservative.

Every bottle has a warning label on the back.

So maybe it's less of those preservatives that are required for export.

So we divide treatment into acute and preventive.

So if you use a lot of acute therapies, like taking sumatriptan constantly like I did, you may want to think about preventive measures.

And Botox is at the top of my list because it's probably the safest treatment there is.

I give it to pregnant women, off-label, not cleared, not approved for pregnant women.

But we know from research that very, very little of it gets out into the bloodstream, and none of it crosses the placenta.

The molecule is too big, 150 kilodaltons, and that's a big molecule to go through the placenta.

So there's no problem at all.

Well, it depends on the frequency of the headaches.

If you have a headache once every other week, you don't need Botox or other preventive measures as long as the acute treatment works.

There are people who have two migraines.