cbd for migraines

Previous research studies have shown that CBD oil, unlike THC, does not cause a euphoric high or psychotropic effects, and is typically less controversial and safer for medicinal use. CBD oil has been shown, in a limited number of studies, to be effective in the treatment of many disorders, including diabetes, arthritis, multiple sclerosis, and migraines.  

Anyone considering the use of CBD oil for migraines should consult with their healthcare provider before taking it. It’s important to note that not all sources of the product are reputable.

Cannabidiol (CBD) is just one of over 100 different substances found in the the Cannabis sativa plant. The portion of the cannabis plant that produces a high (the psychotropic effect) is called tetrahydrocannabinol, or THC. Depending on how it’s processed, CBD oil contains very little (or is completely void of) THC.  

Uses and Safety

The researchers add that given time, as the legalities around medical marijuana and CBD oil change, more research may be able to show that CBD oil works well enough and consistently enough to treat migraines.

With the laws governing the legal use of medical marijuana beginning to loosen up, there’s quite a bit of focus on the use of CBD oil—a component of the marijuana plant—for treating everything from arthritis to chronic pain, including migraines. But what is CBD oil, and does it really work to relieve migraine headaches?

Prescription drugs with CBD do not have any THC at all. But many over-the-counter CBD oil products, such as those sold online, contain trace amounts of THC.  

Research

Verywell / Ellen Lindner

“Cannabinoids—due to their anticonvulsive, analgesic, antiemetic, and anti-inflammatory effects —present a promising class of compounds for both acute [short-term, severe] and prophylactic [preventative] treatment of migraine pain," explained lead study author Pinja Leimuranta, of the University of Eastern Finland. Although the researchers say that we are not completely there yet, they add that CBD oil can “absolutely help relieve some symptoms related to migraines.”  

Different forms of medical cannabis and patients preference

Medical research for medical cannabis use is sparse, given the lack of randomized control studies. Current literature is limited to case reports, case series, cell phone survey applications, and retrospective analyses. In addition, few studies document the improvement of migraine symptoms with medical cannabis use. However, two prospective trials done by Robins et al. and Aviram et al. have noted migraine improvement within their studies [16,17]. Also, there are limited studies that qualify or quantify an ideal dosage and method of cannabis use. Hence, with minimal research studies on the effectiveness of medical cannabis on different medical conditions, review papers are essential to summarize how this compound can be effective in headache and migraine management.

While medical cannabis exists in different forms, there is variability in the ideal dosage for medical cannabis use. Several studies done to determine the “ideal” dosage are described here. Ogborne et al., in 2000, interviewed 50 medical cannabis users recruited via advertisements in newspapers and job boards [26]. The participants were using medical cannabis for various reasons such as HIV, cramps, depression, pain, and migraines [26]. Almost all of the participants smoked cannabis approximately two to three times a day [26]. Baron et al., in 2018, in their electronic survey for the use of medical cannabis in a patient with headache, showed a pattern of cannabis use, including frequency, quantity, and strains [20]. In the ID Migraine™ questionnaire, hybrid strains of cannabis, of which “OG Shark,” a high THC/THCA, low CBD/CBDA, and strains with predominant terpenes β-caryophyllene and β-myrcene, were most preferred in the headache and migraine groups [20]. In the study trial, patients were intervened with 19% THC or THC+ 9% CBD [20]. It was found that a dose of 200 mg effectively reduced the intensity of migraine pain by 55% [20]. In another phase, 25 mg of amitriptyline or THC+CBD 200 mg per day was given prophylactically for three months in chronic migraine patients [20]; also, THC + CBD 200 mg was required for the acute attack [20]. The study concluded that THC + CBD 200 mg had a 40.4% improvement over amitriptyline use (40.1%) [20]. A similar study was done for the cluster headache, but it did not benefit as abortive treatment [20]. Sexton et al., in 2016, did an online survey that sought to collect epidemiological data to start a discussion on medico-legal recommendations, report patient outcomes, and inform the medical practice of medical cannabis users [32]. Many medical professionals (59.8%) used cannabis as an alternative treatment for their patients, reducing the symptoms by 86% [32]. This study also included the route and dosage of medical marijuana usage, where 84.1% of the participants had inhalation as the most common route, and 60.8% of the participants reported one to five hits usage per session [32]. Concerning the dosage of cannabis, 12.3% of respondents used less than 1 g/week, 20.3% reported using 1-2 g/week, 31.8% reported using 3-5 g/week, 26.1% reported using 7 g/week, 6% using 28 g/week, and 3.4% using more than 28 g/week [32]. The survey was limited due to self-reported results, placebo effects, recall bias, and how efficacy was reported [32]. In this situation, the amount utilized per week ranges from 1 to 28 g [26,32]. Frequency is also a concern, as patients vary from “1-10 hits per day” or 2-3 times per day depending on the convention used [26,32].

Conclusions

Cannabis ideal dose and preferred forms

The review article shows encouraging data on medicinal cannabis’s therapeutic effects on alleviating migraines in all of the studies reviewed. Beneficial long-term and short-term effects of medicinal cannabis were reported. It was effective in decreasing daily analgesic intake, dependence, and level of pain intensity. Some patients experienced a prolonged and persistent improvement in their health and well-being (both physically and mentally) after long-term use of medicinal cannabis. Overall, patients reported more positive effects rather than adverse effects with medical cannabis use. Chronic pain and mental health are the two reasons where medical cannabis is used often. It is found that some medical providers are hesitant to recommend medical cannabis due to a lack of current evidence, medical professional training, and a lack of uniform medical cannabis use guidelines. The therapeutic benefits of cannabis should be studied widely with intensive research trials supervised and controlled by authorities for safety and quality effectiveness. Further research should be performed once cannabis becomes legalized to determine a favorable delivery method, dose, and strain for migraine and chronic headache management and possible long-term effects of medical cannabis use. While medical cannabis is in a “disorganized realm” at the moment due to a lack of substantial research and medical provider education and patient education, this field is evolving and expanding to provide up-to-date research for both patient and doctor.

Introduction and background

The authors would like to acknowledge Dr. Marcos A. Sanchez-Gonzalez for his constant support throughout the course of the manuscript. In addition, the authors appreciate the support of Dr. Marie-Pierre Belizaire, Dr. Madiha Zaidi, Prathima Guntipalli, and Rahima Taugir. Finally, the authors would like to thank the reviewers for their constructive feedback.

After reviewing the literature, it is found that the primary method for cannabis use was smoking, followed by vaporization (5.6%) and dabs (2.8%) [27]. Patients with headaches were 2.7 times more likely to prefer a hybrid (Cannabis sativa + Cannabis indica) strain than chronic pain patients [20]. Females preferred to rank edible, tincture (oil-based), and topical cannabis as preferred first-line methods for chronic pain like arthritis and migraine [30]. Also, analysis of Strainprint responses reveals that inhalation methods like smoking, vaping, concentrates, dabs (79.4% of headache data and 82.8% of migraine data) were primary methods used by the patients [19].