What do I do now that Botox or Myobloc is not working?

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I was diagnosed with adductor spasmodic dysphonia in 2004. I received my first Botox injection in 2006 from the NIH in Bethesda, Md. as part of their clinical studies. I received injections until 2009 when I was told I had developed antibodies to the Botox and it was no longer working. A few months later in 2009, my doctor in Orlando, Florida started using Myobloc and it worked beautifully. I have started having less and less results the last 4 months and after my injection yesterday, it is not working at all. What is available besides these 2 medicines to relieve the spasms? Are there any other medicines available to give me a good voice?? 
 
Debra Anderson
James P Thomas MD's picture
Submitted by James P Thomas MD on Sat, 2012-04-07 12:51

I have read scientific literature that suggests it is possible to develop antibodies to botulinum toxin. However, I have also met patients who were told they had antibodies and yet I was still able to treat them with botulinum toxin. In my experience, I have found that technique of injection more often affects outcome then development of antibodies. See comments on "The art of the injection". Consequently, while I don't know of other medications, there are times when seeing a different physician who utilizes a different approach or technique or injects a different muscle can lead to a different outcome.