Migraine

PrintMigraine is a reoccurring headache syndrome that can last for up to 72 hours if left untreated. About 14 percent of Americans, primarily women, suffer from migraines. Migraine effects include pulsing cranial pain, nausea, light sensitivity, dizziness, difficulty speaking, and confusion, among other symptoms.

The endogenous cannabinoid system is suspected to play a significant role in migraine pathophysiology[1-3] and several studies have identified differences in ECS functioning and the production of endocannabinoids in migraine sufferers versus controls.[4-7]

Cannabis possesses a long history of human use in the treatment of migraines.[8-10] Recent survey data reports that nearly one-third of patients with migraines have utilized cannabis for symptom management, and the majority of those who have done so report that it is effective.[11] Among patients who were recommended medical cannabis, as many as two-thirds reported decreasing their use of conventional medications to treat migraines.[12-13] Separate survey data compiled from migraine sufferers who use both cannabis and conventional anti-migraine treatments reports that the majority of subjects find cannabinoids to be more effective at mitigating their symptoms.[14]

In recent years, several studies have documented the efficacy of inhaled cannabis and/or plant-derived extracts for patients with migraines. A retrospective assessment of 121 adults with a primary migraine diagnosis reported, “Migraine headache frequency decreased from 10.4 to 4.6 headaches per month with the use of medical marijuana.” Inhaling cannabis was also reported by many patients to abort the onset of migraines.[15] Observational trial data presented in 2017 at the 3rd Congress of the European Academy of Neurology reported that the daily administration of cannabinoid extracts resulted in a 40 percent reduction in migraine frequency in a cohort of 79 chronic migraine patients.[16]

In 2019, Washington State University reviewed archived data from 1,959 anonymous cannabis consumers who tracked their cannabis use and headache frequency over a 16-month period via an online application. Authors reported that inhaled cannabis reduced subjects’ perceived severity of headache and migraines by nearly 50 percent. Men were more likely than women to report changes in headache severity.[17]

Longitudinal data published in 2020 reported that patients who engage in cannabis inhalation for extended periods of time typically report reductions in migraine frequency. The majority of participants in the study (61 percent) reported a greater than 50 percent reduction in monthly migraine attacks following the initiation of cannabis therapy, and most reduced their use of conventional anti-migraine medications.[18]

Separate patient data presented at the 2020 annual meeting of the American Headache Society reported similar results. Researchers affiliated with the Jefferson Headache Center at Thomas Jefferson University in Philadelphia evaluated the efficacy of marijuana use for patients with migraines over nine months. A majority of patients reported reductions in their use of prescription medications during the course of the trial. On a scale of one to ten, 20 percent of subjects rated marijuana’s efficacy in treating migraines as a 10.[19]

Most recently, a team of investigators affiliated with the University of New Mexico assessed the effects of herbal cannabis inhalation on migraines in 699 subjects over a 32-month period. Study participants self-administered cannabis at home and reported symptom changes in real time on a mobile software application. Researchers reported that 94 percent of subjects experienced symptom relief within two hours of marijuana inhalation. On average, patients experienced a reduction in symptom intensity of 3.3 points on the 10-point scale. Varieties of cannabis that contained higher THC content (above 10 percent) were most closely associated with providing symptom relief.

Authors of the study concluded: “According to the current results, cannabis flower appears to be effective at reducing headache- and migraine-related pain intensity for most people that choose to use it. … It seems possible that the use of cannabis flower, combined with other behavioral modifications, might offer some patients a natural, safer and more effective treatment regimen, compared to the use of some conventional prescription pharmaceuticals.”[20]

REFERENCES

[1] Ethan Russo. 2016. Clinical Endocannbinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistent Syndromes. Cannabis and Cannabinoid Research 1: 154-165.

[2] Ethan Russo. 2004. Clinical endocannabinoid deficiency (CECD): Can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinology Letters 25: 31-39.

[3] Greco et al. 2010. The endocannabinoid system and migraine. Experimental Neurology 224: 85-91.

[4] Cupini et al. 2003. Abnormal degradation of endocannabinoids in migrainous women. Cephalalgia 23: 684.

[5] Sarchielli et al. 2007. Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology 32: 1384–1390.

[6] Cupini et al. 2008. Degradation of endocannabinoids in chronic migraine and medication overuse headache. Neurobiology of Diseases 30: 186–189.

[7] Rossi et al. 2008. Endocannabinoids in platelets of chronic migraine patients and medication-overuse headache patients: relation with serotonin levels. European Journal of Clinical Pharmacology 64: 1-8.

[8] Ethan Russo. 2001. Hemp for Headache: An In-Depth Historical and Scientific Review of Cannabis in Migraine Treatment. Journal of Cannabis Therapeutics 1: 2 1–92.

[9] E. Baron. 2015. Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache. Headache 55: 885-916.

[10] Lochte et al. 2017. The use of cannabis for headache disorders. Cannabis and Cannabinoid Research 2 [open access journal].

[11] Healint, September 23, 2020. “New Study Reveals 30% of Migraine Sufferers in American Have Tried Cannabis For Migraine Relief.” 

[12] Piper et al. 2017. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. Journal of Psychopharmacology 31: 569-575.

[13] Sexton et al. 2017. A cross-sectional survey of medical cannabis users: Patterns of use and perceived efficacy. Cannabis and Cannabinoid Research 1: 131-138.

[14] Gibson et al. 2021. Experience of migraine, its severity, and perceived efficacy of treatments among cannabis usersComplimentary Therapies in Medicine [open access journal].

[15] Rhyne et al 2016. Effects of medical marijuana on migraine headache frequency in an adult population. Pharmacotherapy 36: 505-510.

[16] Kassam. June 29, 2017. “Cannabinoids suitable for migraine prevention. European Pharmaceutical Review.

[17] Cuttler et al. 2019. Short- and Long-Term Efects of Cannabis on Headache and MigraineJournal of Pain 21: 722-730. 

[18] Aviram et al. 2020. Migraine frequency decrease following prolonged medical cannabis treatment: A cross-sectional studyBrain Sciences 10 [open access journal].

[19] Medscape, July 25, 2020, “Marijuana for Migraine? Some Tentative Evidence.”

[20] Stith et al. 2020. Alleviative effects of cannabis flower on migraine and headacheJournal of Integrative Medicine 18: 416-424.