Cannabis Prevents and Aborts Migraines: Not Exactly Breaking News
[dropcap class=”kp-dropcap”]A[/dropcap]lthough the use of cannabis to treat headaches has been known for millennia, hostile adversaries continue to oppose the reintroduction of cannabis into our pharmacopeia demanding that scientific proof must be developed to prove its safety and efficacy. Fortunately for humanity, two diligent Assistant Professors at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Science have just issued a report to confirm the validity of this millennial old use of cannabis to both treat and prevent migraine headaches. Dr. Danielle Rhyne specializes in geriatric pharmacological studies providing clinical pharmacy services for elderly patients including transitions of care, chronic care management, pharmacotherapy consults, and drug information. Dr. Sarah Anderson is Clinical Pharmacy Specialist in Adult Internal Medicine providing pharmacotherapy consultations and patient care visits for resistant hypertension, diabetes, anticoagulation, hospital discharge follow-up, and general medication management.
Left: Sarah Anderson, Right: Danielle Rhynne
What is a migraine?
Dr. Anderson: A migraine is defined as common episodic disorder the hallmark of which is a headache. People can have migraines and have other symptoms but the most common symptom is a headache.
Why do people get migraines?
Dr. Rhyne: The exact mechanism of action behind migraines is not fully understood but there is evidence that neurotransmitters like serotonin are involved and that a decrease of serotonin in the brain could cause migraines.
Anderson: Depending on the individual patient they may have other symptoms associated with a migraine that are not necessarily headache related but a headache is a symptom that is very much associated with a migraine. Not all headaches are migraines—you can have tension headaches, you can have cluster headaches – there are other types of headaches besides just migraines.
How did you come to study migraines and cannabis?
Rhyne: During my first year of residency I heard quite a few questions from physicians about medicinal cannabis and how cannabis can be used by patients. After doing some reading I realized that there was not much information out there.
During my 2nd year of residency I had a preceptor who knew a physician who ran a medical marijuana clinic. The physician noticed that a lot of her patients would come in with migraine headaches and that marijuana seemed to be effective for those patients. We decided to conduct a research study to see how patients were using marijuana and the effects that it had on the number of headaches they had per month.
Do you find cannabis to be effective in treating migraines?
Rhyne: We found that patients who used marijuana did have a decrease in the number of headaches per month. With marijuana use, the average number of headaches went from 10 headaches per month down to 4.6 headaches per month.
How do patients use cannabis to treat migraine headaches?
Anderson: Many patients who had multiple migraines per month reported that vaporizing marijuana would stop their headache and that edible marijuana would prevent them from having a headache. A fairly common patient scenario would be taking an edible with 10 to 20 mgs of THC at bedtime. If they felt like they were having a headache the next day, they would use vaporized marijuana to help stop the headache.
Was smoking cannabis as effective as vaporizing?
Anderson: Yes—smoking was very common, but the provider at the clinic would educate patients about the potential risks of smoking marijuana and encourage them to use vaporizers as it is safer for the lungs, but smoking did have the same effect on migraines as vaporizing.
How does aspirin compare in its effectiveness in treating headaches to cannabis?
Anderson: Aspirin is not the drug of choice for migraine headaches. Aspirin is very commonly used by patients for tension type headaches or cluster type headaches, but for patients who had migraine type headaches it tends to be prescription medications like Imitrex or the generic triptans.
How does Imitrex compare in effectiveness in treating migraine headaches as compared to cannabis?
Rhyne: Currently, there are no studies comparing Imitrex to marijuana so the comparison cannot be made. Imitrex is used for acute treatment of migraine. In our study, we had patients using marijuana for both acute treatment as well as preventative therapy. Studies comparing the two are needed in order to know the differences in effectiveness.
How does cannabis work to prevent or relieve headaches?
Rhyne: Cannabis has analgesic and anti-inflammatory properties acting on cannabinoid receptors that are located throughout the body. When patients use marijuana the cannabis goes to these cannabinoid receptors causing inflammation and pain to decrease.
So migraines are caused by inflammation?
Rhyne: Correct. There are a few other mechanisms out there dealing with serotonin that are thought to be related to migraines. They are believed to activate 5HT receptor sites which is the same mechanism of action as the triptans which means marijuana may have the same mechanism of action as triptan in the brain.
Would you use cannabis to treat your migraines?
Rhyne: – I would first use the approved therapies like the triptans and see if they were effective. If not, then it would be a conversation I would have with my provider to make sure cannabis would be a safe option and then I would be a little more likely to try marijuana.
