Cannabinoids as effective as pharmaceutical treatments for migraine attacks
However, when it comes to reducing acute pain, they are only effective in patients that suffered migraines from childhood.
These findings were presented at the Congress of the European Academy of Neurology in Amsterdam after a research team investigated the suitability of cannabinoids as a prophylaxis for migraine and in the acute treatment of migraines and cluster headaches.
A group of 48 chronic migraine volunteers were given a starting oral dose of two compounds. One contained 19 per cent tetrahydrocannabinol (THC), and while the other had virtually no THC, it had a 9% cannabidiol (CBD) content. The outcome was that doses of less than 100mg produced no effects. It was not until an oral dose of 200mg was administered that acute pain dropped by 55%.
In phase two of the study, 79 chronic migraine patients were given a daily dose of either 25mg of amitriptyline — a tricyclic antidepressant commonly used to treat migraine — or 200mg of the THC-CBD combination for a period of three months. Forty-eight cluster headache patients also received either 200mg THC-CBD or a daily dose of 480mg of the calcium channel blocker verapamil. For acute pain, an additional 200mg TCH-CBD was administered for both types of headaches.
The results after three months of treatment and follow-up after a further four weeks revealed that the TCH-CBD combination yielded slightly better results with a 40.4% reduction in attacks, compared with a 40.1% reduction with amitriptyline. However, the severity and number of cluster headache attacks only fell slightly.
When analysing use in the treatment of acute pain, the researchers came across an interesting phenomenon; cannabinoids reduced pain intensity among migraine patients by 43%. The same results were seen in cluster headache patients, but only in those that had experienced migraine in childhood. In patients without previous history, THC-CBD had no effect whatsoever as an acute treatment.
“We were able to demonstrate that cannabinoids are an alternative to established treatments in migraine prevention. That said, they are only suited for use in the acute treatment of cluster headaches in patients with a history of migraine from childhood on,” said Dr Maria Nicolodi.
Drowsiness and difficulty concentrating aside, the side effects observed during the study were “highly positive”, with the incidence of stomach ache, colitis and musculoskeletal pain decreasing, especially in female subjects.