Efficacy and Safety of Medical Marijuana in Migraine Headache: A Systematic Review

Sherpa, Mingma; Shrestha, Nilasma; Ojinna, Blessing  T; Ravi, Niriksha; Kumar, Vivig Shantha; Choday, Silpa; Parisapogu, Anusha; Tran, Hadrian Hoang-Vu; KC, Anil; Elshaikh, Abeer O

doi:10.7759/cureus.32622

Cited by 5 publications

(5 citation statements)

References 14 publications

(99 reference statements)

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“…Although cannabinoids have been suggested as a potential migraine treatment, the evidence about their efficacy and tolerability is lacking [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine

Greco¹,

Francavilla

Demartini

et al. 2023

J Headache Pain

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Cannabidiol (CBD) is the main pharmacologically active phytocannabinoid. CBD exerts an analgesic effect in several pain models, does not have side effects and has low toxicity. The data about CBD mechanisms of action in pain and its therapeutic potential in this area are limited. Here, we tested CBD effects in animal models specific for migraine. We assayed CBD distribution in plasma and in cranial areas related to migraine pain in male Sprague Dawley rats treated chronically (5 days). Successively, we tested CBD activity on the behavioral and biochemical effects induced in the acute and the chronic migraine animal models by nitroglycerin (NTG) administration. In the acute migraine model, rats received CBD (15 mg or 30 mg/kg, i.p) 3 h after NTG (10 mg/kg i.p.) or vehicle injection. In the chronic migraine model, rats were treated with CBD and NTG every other day over nine days with the following doses: CBD 30 mg/kg i.p., NTG 10 mg/kg i.p. We evaluated behavioral parameters with the open field and the orofacial formalin tests. We explored the fatty acid amide hydrolase gene expression, cytokines mRNA and protein levels in selected brain areas and CGRP serum level. CBD levels in the meninges, trigeminal ganglia, cervical spinal cord, medulla pons, and plasma were higher 1 h after the last treatment than after 24 h, suggesting that CBD penetrates but does not accumulate in these tissues. In the acute model, CBD significantly reduced NTG-induced trigeminal hyperalgesia and CGRP and cytokine mRNA levels in peripheral and central sites. In the chronic model, CBD caused a significant decrease in NTG-induced IL-6 protein levels in the medulla–pons, and trigeminal ganglion. It also reduced CGRP serum levels. By contrast, CBD did not modulate TNF-alpha protein levels and fatty acid amide hydrolase (FAAH) gene expression in any of investigated areas. In both experimental conditions, there was no modulation of anxiety, motor/exploratory behavior, or grooming. These findings show that CBD reaches brain areas involved in migraine pain after systemic administration. They also show for the first time that CBD modulates migraine-related nociceptive transmission, likely via a complex signaling mechanism involving different pathways.

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“…Although cannabinoids have been suggested as a potential migraine treatment, the evidence about their efficacy and tolerability is lacking [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine

Greco¹,

Francavilla

Demartini

et al. 2023

J Headache Pain

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“…Additionally, there was a substantial reduction in the use of prescribed opioids in these patients [56]. Further observational studies of patients using CBMPs have reported improvements in pain [57][58][59][60][61][62].…”

Section: Pain (Including Migraine Headaches)mentioning

confidence: 88%

“…The authors discuss a growing body of small randomized controlled clinical trials using CBD for anxiolytic effects; however, many were in healthy volunteers rather than relevant patient cohorts [72]. RWE highlights the potential value of CBMPs to reduce anxiety symptomatology and improve patients' well-being and sleep [40,56] and observational studies of CBMPs have also demonstrated improvements in anxiety [59,61,62,73]. There is a need for further investigation into which CBMPs may offer therapeutic benefits in anxiety, as well as the dosing schedule and treatment duration.…”

Section: Anxietymentioning

confidence: 99%

“…Although there is limited data from RCTs for CBMPs in fibromyalgia [77], fibromyalgia is a common condition for which patients seek CBMPs in the real-world setting [40]. An observational study investigating CBMP in pain conditions, including 132 patients with fibromyalgia out of 751, reported reductions in fatigue as well as decreases in pain, headaches, fatigue, anxiety, and nausea [62].…”

Section: Fatiguementioning

confidence: 99%

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Cannabis-based medicinal products (CBMPs) for the treatment of Long COVID symptoms: current and potential applications

Thurgur,

Schlag,

Iveson

et al. 2023

Exploration of Medicine

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can result in a range of persistent symptoms impacting everyday functioning for a considerable proportion of patients, a condition termed Long coronavirus disease (COVID) or post COVID-19 syndrome. The severity and set of symptoms vary between patients, and include fatigue, cognitive dysfunction, sleep disturbances, palpitations, tachycardia, pain, depression, and anxiety. The high prevalence of Long COVID combined with the lack of treatment approaches has resulted in considerable unmet clinical needs. There is a growing body of evidence that cannabis-based medicinal products (CBMPs) can be used to treat symptoms including pain, anxiety, depression, fatigue, sleep, headaches, and cognitive dysfunction, which are commonly reported in Long COVID. This article provides an overview of the pathophysiology of Long COVID and discusses preliminary pre-clinical, clinical trials, and real-world evidence (RWE) for CBMPs in the context of Long COVID. This review summarises current clinical trials and studies exploring CBMPs in Long COVID. The current evidence provides a rationale to further explore CBMPs as a treatment for Long COVID symptoms. In addition to further randomised controlled trials (RCTs), the increasing availability of CBMPs globally, coupled with the continued prevalence of Long COVID in the population, also highlights the value of real-world data in the research of CBMPs in Long COVID. Critically, there is an evident need for multidisciplinary approaches of CBMPs and Long COVID in real-world clinical practice settings.

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“…Apesar do crescente interesse e da crescente legalização em muitas partes do mundo, o uso terapêutico da Cannabis ainda é um tema controverso e sujeito a regulamentações rigorosas em muitos países. Essa controvérsia é, em parte, devido à falta de pesquisa robusta e evidências científicas claras sobre os benefícios e riscos associados ao uso da Cannabis para fins medicinais (Whiting et al, 2015;Sherpa et al, 2022).…”

Section: Introductionunclassified

Cannabis Medicinal: Uma Revisão sobre as Perspectivas Atuais e Desafios Futuros na Prática Clínica

Xavier Viana,

De Paula Venute,

Teixeira Coelho

et al. 2024

J. Res. Med and Health

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Introdução: A crescente atenção pela Cannabis medicinal, reflete interesses em suas propriedades terapêuticas, que são exploradas desde os povos ancestrais. Compostos como o tetra-hidrocanabinol (THC) e o canabidiol (CBD) despertam interesse científico devido às suas potenciais aplicações medicinais. Objetivo: Fornecer uma visão abrangente do potencial terapêutico da Cannabis medicinal e suas aplicações clínicas. Métodos: Trata-se de uma revisão integrativa da literatura científica disponível nas bases de dados PubMed (US National Library of Medicine), SciELO (Scientific Electronic Library Online) e Web of Science. Foram selecionados estudos que se relacionavam com o uso terapêutico da Cannabis em diferentes condições médicas, utilizando os seguintes critérios de inclusão: descritores cadastrados do Decs (((Medical Marijuana) AND (Therapy)) AND (Clinical)) AND (Diseases)), textos completos gratuitos, publicados em revistas revisadas por pares, artigos disponíveis em inglês e português, e publicados nos últimos 5 anos (2019 a 2024). Os estudos que não estavam diretamente relacionados ao tema proposto foram excluídos da análise. Resultados: Esta revisão analisou um total de 81 artigos, dos quais apenas 8 foram considerados pertinentes para o tema em estudo. O estudo evidenciou uma variedade de aplicações clínicas da Cannabis medicinal, incluindo alívio da dor, redução da ansiedade e controle de convulsões em pacientes com epilepsia, entre outros. Esses resultados fornecem informações valiosas para profissionais de saúde e pesquisadores interessados no potencial terapêutico da Cannabis. Conclusão: A Cannabis medicinal apresenta um potencial terapêutico significativo em várias aplicações clínicas, oferecendo uma alternativa promissora para pacientes que buscam tratamentos complementares ou alternativos. No entanto, são necessárias mais pesquisas para elucidar os mecanismos de ação e otimizar sua utilização clínica.

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Efficacy and Safety of Medical Marijuana in Migraine Headache: A Systematic Review

Cited by 5 publications

References 14 publications

Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine

Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine

Cannabis-based medicinal products (CBMPs) for the treatment of Long COVID symptoms: current and potential applications

Cannabis Medicinal: Uma Revisão sobre as Perspectivas Atuais e Desafios Futuros na Prática Clínica

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