Pain to the point of unbearability: A migraine attack paralyzes the life of those affected. Migraine patients usually spend years looking for the right acute medication and attack prophylaxis. There are many approved medications, but some of them are poorly tolerated or do not work. To use cannabinoids for migraine showed positive results: They reduced migraine attacks, the negative impact of the disease on everyday life, and the use of painkillers.
Migraine – the big burden
Migraine is a recurring, usually unilateral headache that is often accompanied by nausea, vomiting, and sensitivity to noise and light.
About 10 to 30 percent of those affected also suffer from an aura. This refers to temporary neurological deficits, such as visual disturbances, numbness or double vision. The aura occurs only temporarily and does not leave any permanent damage.
Along with tension headache, migraine is one of the most common headache disorders. For a long time, the impairment of patients with migraine was underestimated.
The Global Burden of Disease surveys revealed both the prevalence of headache disorders and the extraordinary burden of migraine. (1) Globally, 10 to 15 percent of adults suffer from migraine. Approximately 6 to 8 percent of all men and 12 to 14 percent of all women are affected. Women are not only more likely to suffer from migraines, but their attacks tend to be longer and more intense. (2)
According to the German Migraine and Headache Society (DMKG), about 3.7 million women and about 2 million men suffer from migraine in Germany alone.
Migraine occurs most frequently between the ages of 35 and 45. After that, the severity and frequency of migraine attacks decrease in both sexes. Studies show that about 4 to 5 percent of children also suffer from migraine.
It is estimated that migraine causes the loss of about 270 working days per year per thousand people in the working population. Almost all sufferers complain that migraine attacks interfere with their daily lives. For about one-third, the condition causes them to neglect their family responsibilities, leading to domestic problems. Nevertheless, about half of migraine patients in Germany do not seek medical care despite their symptoms. (2)
Medical cannabis and migraine
Can medical cannabis provide relief from migraine attacks? A 2022 review examined the efficacy and safety of cannabinoids for migraine. For this purpose, a total of 12 publications with 1,980 patients* were selected from several medical-scientific portals (PubMed, EMBASE, PsycINFO, CINAHL, Web of Science).
Cannabis up to 51% more effective
The studies evaluated found that medical cannabis could significantly reduce nausea and vomiting from migraines after 6 months of use. It provided a reduction in the number and frequency of migraines after just 30 days.
Medical cannabis was 51 percent more effective in reducing migraines than products without cannabis. Compared to amitriptyline, cannabinoids were able to stop migraine attacks in about 12 percent of patients* and otherwise reduce frequency. Mild side effects occurred in less than half of those taking cannabis orally. (3)
Reduction in attacks, decreased use of painkillers.
An Israeli survey of patients with comorbid migraine also showed that people taking plant cannabinoids (phytocannabinoids) suffered from painful attacks significantly less often. (4)
In the cross-sectional study, 145 sufferers (67 percent of whom were women) were asked about the frequency of their migraine attacks and their therapy with pharmaceutical cannabis. All respondents had taken phytocannabinoids – as extract or inhaled – for an average of three years beforehand.
Another requirement was comorbidity of migraine: that is, all subjects suffered from additional conditions that warranted treatment with cannabinoids.
More than 60 percent of respondents reported a long-term reduction in migraine attacks, less impact on performance at school, work or home, and better sleep quality. In addition, their use of pain medication was lower than that of the control group. They also experienced fewer side effects.
Conclusion
As studies show, medical cannabis can:
- Have positive effects on the frequency and incidence of migraines,
- Significantly reduce nausea and vomiting
- Reduce negative effects of migraine on performance,
- Improve sleep quality.
However, further experimental studies evaluating the safety and efficacy of cannabis in migraine would be needed to reliably assess this.
Sources
(1) Ganser, B., Leis, S. Ätiologie und Pathogenese der Migräne. psychopraxis. neuropraxis 23, 76–81 (2020). https://doi.org/10.1007/s00739-020-00623-x
(2) Deutschen Migräne- und Kopfschmerzgesellschaft e.V. (DMKG)
(3) Okusanya BO, Lott BE, Ehiri J, McClelland J, Rosales C. Medical Cannabis for the Treatment of Migraine in Adults: A Review of the Evidence. Front Neurol. 2022 May 30;13:871187. doi: 10.3389/fneur.2022.871187. PMID: 35711271; PMCID: PMC9197380.
(4) Aviram J, Vysotski Y, Berman P, Lewitus GM, Eisenberg E, Meiri D. Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study. Brain Sci. 2020 Jun 9;10(6):360. doi: 10.3390/brainsci10060360. PMID: 32526965; PMCID: PMC7348860.