Promising New Results on Cannabis for Migraine

Many women in our group, including myself, use cannabis to help alleviate the pain and nausea from hemiplegic migraine. There is promising evidence that MC may have a beneficial effect on the onset and duration of migraine headaches in adults.

Cannabis, or marijuana as it is commonly referred to, has been used for centuries to treat several ailments. Anecdotal client reports indicate benefits from marijuana or cannabidiol, a constituent of MC. In a survey of medical use of cannabis products in Germany, Austria, and Switzerland, 10.2% of patients with migraine reported self-use of cannabis. In another study, 35% of respondents in the North American population reported using MC for headaches/migraine. In the State of Arizona, United States, MC use is predominantly (94%) for chronic pain, including migraines, by MC cardholders.

This review's objective was to assess the effectiveness and safety of MC in the treatment of migraine in adults. PubMed, EMBASE, PsycINFO, CINAHL, and Web of Science were searched for eligible studies in adults aged 18 years and older to assess the effectiveness and safety of MC in the treatment of migraine in adults. A total of 12 publications involving 1,980 participants in Italy and the United States of America were included. Two reviewers independently screened studies for eligibility.

Medical cannabis significantly reduced nausea and vomiting associated with migraine attacks after 6 months of use. Also, MC reduced the number of days of migraine after 30 days, and the frequency of migraine headaches per month. MC was 51% more effective in reducing migraines than non-cannabis products. Compared to amitriptyline, MC aborted migraine headaches in some (11.6%) users and reduced migraine frequency. While the use of MC for migraines was associated with the occurrence of medication overuse headaches (MOH), and the adverse events were mostly mild and occurred in 43.75% of patients who used oral cannabinoid preparations.

In a sub-group analysis of 284 MC users, Stith et al. reported symptom relief within 2 hours. In another observational study involving 121 adult patients, the mean number of migraines per month decreased significantly from 10.4 at the initial visit to 4.6 per month at follow-up. In the Rhyne et al. study, the positive (abortion of headaches) effects of MC were reported by 39.7% of patients, and negative effects were reported by 11.6% of patients. Among 653 MC users, migraine severity was reduced in 87.3% of men and 88.6% of women, with a migraine rating reduction of 49.6%.

Although more well-designed experimental studies are needed to that assess MC's effectiveness and safety for treating migraine, these results are promising. The evidence in this review demonstrates MC's potential for both prophylactic and abortive treatment of migraine.

Source: Medical Cannabis for the Treatment of Migraine in Adults: A Review of the Evidence, Front. Neurol., 30 May 2022