The pain management specialist and headache neurologist at the University of California San Diego Center for Pain Medicine discussed promising findings from a placebo-controlled trial assessing cannabis in patients with migraine. [WATCH TIME: 5 minutes]
WATCH TIME: 5 minutes
"The doses that we used are probably lower than what a lot of people out there are using on their own, and higher doses does not necessarily mean more effective. The highness patients were having in the study was not very high, probably somewhere between a 2-4 out of 10 on subjective highness.”
Medical use of cannabis has been receiving growing attention over the last few years in modern medicine, especially as it becomes more legalized throughout the country. There are well-known risks of long-term use of cannabis, including low motivation, lowered cognitive capabilities, and diminished IQ and brain mass. While it has been studied in various neurological disorders, research on its impacts on migraine have been limited.
At the 2023 American Headache Society (AHS) Annual Meeting, held June 15-18, in Austin, Texas, Nathaniel Schuster, MD, presented data from a double-blind, placebo-controlled, crossover, randomized controlled trial of vaporized cannabis as a potential acute treatment of migraine. Prior to this research, most of the studies on cannabis and migraine were relatively small, retrospective, with no placebo control involved. Conducted from November 2020 to February 2023, patients were randomly assigned to either tetrahydrocannabinol (THC) 6%, a mix of THC and cannabinoid (CBD) 11%, CBD 11%, and placebo cannabis.
Patients underwent at least a 1-week washout period between treated migraine attacks. At the conclusion of the trial, 4 puffs of vaporized THC/CBD mix flower was efficacious for acute migraine treatment, showing impacts on 2 hour pain relief and freedom, as well as resolution of most bothersome symptom 2 hours after migraine attack. Schuster, a pain management specialist and headache neurologist at the University of California San Diego Center for Pain Medicine, sat down with NeurologyLive® to provide an overview of the trial, the most notable take-home points, and the history of cannabis in migraine. He discussed the reasons for the design of the trial, and why cannabis can be an effective alternative when used correctly.