A study presented at the Congress of the European Academy of Neurology (Amsterdam, The Netherlands, 24–27 June 2017) has confirmed that cannabinoids are suitable for migraine prophylaxis. The study – led by Maria Nicolodi (Interuniversity Center, Florence, Italy) – investigated the use of cannabinoids for migraine prevention as well as the treatment of migraine and acute cluster headaches. Interestingly, findings indicated that cannabinoids are only effective at treating acute cluster headaches in patients who have suffered from migraine in childhood.
Researchers first investigated the effective dosage of cannabinoids for treating headaches. After administrating varying oral doses containing concentrations of 19% tetrahydocannabinol (THC) and 9% cannabidol (CBD), they observed that doses of less than 100 mg produced no effects, and that only doses of 200 mg or more led to a reduction in acute pain of 55%.
In Phase II of the study, 79 chronic migraine patients received a daily dose of either 25 mg amitriptyline (a tricyclic antidepressant often used to treat migraine) or 200 mg of the THC-CBD combination for 3 months. In addition, 48 cluster headache patients received either 200 mg THC-CBD or a daily dose of 480 mg verapamil. 200 mg TCH-CBD was also administered for acute pain relief for both types of headache.
Follow-up after 3 and 4 months demonstrated a 40.4% reduction in migraine attacks in the THC-CBD group compared with 40.1% reduction in the amitriptyline group. The severity and number of cluster headache attacks fell only slightly.
Interestingly, cannabinoids were found to reduce pain intensity in migraine patients by 43.5%, yet the same results were only observed in cluster headache patients who had experienced migraine in childhood. In cluster headache patients with no migraine history, THC-CBD had no effect.
Nicolodi commented: “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.”