Marijuana for migraine
Some people use marijuana, or forms of the cannabis plant, as a treatment for migraine. Cannabis has been used for thousands of years as a natural remedy for a number of conditions. While there have not been enough high quality studies to support the use of marijuana for migraine, there is sufficient anecdotal reports and preliminary results from researchers to warrant clinical trials. These trials are needed before marijuana can be considered a standard approach to migraine.
Traditionally, the smoking form of cannabis has been called marijuana, although some oral formulations are now also called marijuana. While cannabis for recreational or medicinal use is illegal by federal law, several individual states have passed laws making medical marijuana legal, and a few states have also made recreational use of marijuana legal. Each individual should consult with their doctor and the laws of the state they reside in before considering the possibility of using medical marijuana.
How does medical marijuana work in the body?
Researchers have discovered that the human body has an endocannabinoid system (ECS). (“Endo” means internal or within the body.) The ECS is distributed throughout the body and plays a part in regulating many functions, including pain, mood, appetite, and the movement of the gastrointestinal system. The ECS is comprised of the cannabinoids the body produces, the receptors on which they act, and the enzymes that are involved.
What are the differences between CBD and THC?
While there are over a hundred different compounds (called cannabinoids) in cannabis, the two most commonly studied are THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol). THC has been associated with reduction of nausea and pain, increased appetite, and psychological effects like euphoria, anxiety, and altered sensory perception, which can make users feel “high” or intoxicated. CBD does not produce intoxicating effects, but it produces sedative effects that can help reduce pain, convulsions, nausea, and inflammation. There are a variety of preparations with varying doses of CBD and THC.
Studies on medical marijuana and migraine
Research on marijuana has been limited, due to the federal regulations and lack of funding. However, there have been recent studies on the use of cannabis or medical marijuana in people with migraine.
In 2016, a retrospective analysis was published that reviewed data from 121 adults with migraine who were recommended either a migraine preventive medicine or medical marijuana by their physician. The study found that the frequency of migraine attacks decreased from 10.4 to 4.6 a month with the use of medical marijuana. The types of marijuana used varied, and many patients used more than one form and used it daily as a prevention strategy. Inhaled forms of marijuana were used most frequently as an acute strategy for migraine attacks and were reported to help ease migraine symptoms.1 The challenges with this study are the variations in the forms and dosages used of marijuana. It is impossible to know which form or dosage works best as a preventive or acute treatment, but the study provides interesting data to warrant further investigation.
In a presentation to the Congress of the European Academy of Neurology in 2017, Italian researchers provided additional evidence on the use of cannabis for both prevention and acute treatment of migraine. The researchers first studied the proper dose of cannabis. A group of 48 people with chronic migraine were given oral doses of medical marijuana with varying levels of THC and CBD. Investigators found that at an oral dose of 200mg, acute pain dropped by 55%. In phase two of the research, 79 chronic migraine sufferers were given either a daily dose of marijuana or amitriptyline (a common antidepressant used as a treatment for migraine). The participants were also able to use 200mg of marijuana for acute attacks. After three months, those who received marijuana had a 40.4% reduction in migraine attacks compared to 40.1% of those who received the antidepressant. Researchers also found that the medical marijuana used for acute treatment reduced pain intensity by 43.5%. The most common side effects were drowsiness and difficulty concentrating. In addition, many participants noted an improvement in stomach aches and musculoskeletal pain.2
Side effects and other precautions
Marijuana is not approved by the U.S. Food and Drug Administration. Because marijuana is not tightly regulated the way approved drugs are, it is difficult to list side effects because its strength and purity may vary with each use.
The long-term negative effects of medical marijuana are not known. Few studies have been conducted on the long-term safety of cannabis, and those that have been completed are often conflicting or are of poor quality.
Short-term side effects of medical marijuana are better understood and include:
- Temporary impaired short-term memory and concentration
- Increased in anxiety or paranoia
- Possible physical or psychological dependence or addiction
- Impaired motor skills
- Increased heart rate
- Lowered blood pressure
Who should not take marijuana
If you are pregnant, plan to become pregnant, or are breastfeeding, you must consult your doctor before taking any supplement. It is well-known that smoking endangers the health of developing babies and should be avoided by pregnant women. The effects of marijuana have not been studied in pregnant or breastfeeding women, and it is not known whether marijuana may pose dangers to the child.
As always, the best source for advice on treating migraine is your own migraine specialist. These descriptions of natural remedies are provided only for informational purposes. You should begin no medication or supplement without first checking with your physician.
- Rhyne DN, et al. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy. 2016 May;36(5):505-10. doi: 10.1002/phar.1673. Epub 2016 Jan 9. Abstract.
- Cannabinoids suitable for migraine prevention. June 24, 2017. Congress of the European Academy of Neurology. Available at https://www.ean.org/amsterdam2017/fileadmin/user_upload/E-EAN_2017_-_Cannabinoids_in_migraine_-_FINAL.pdf. Accessed 5/10/18.