Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey

Abstract

Cluster headache is one of the most debilitating pain syndromes. A significant number of patients are refractory to conventional therapies. The Clusterbusters.org medication use survey sought to characterize the effects of both conventional and alternative medications used in cluster headache. Participants were recruited from cluster headache websites and headache clinics. The final analysis included responses from 496 participants. The survey was modeled after previously published surveys and was available online. Most responses were chosen from a list, though others were free-texted. Conventional abortive and preventative medications were identified and their efficacies agreed with those previously published. The indoleamine hallucinogens, psilocybin, lysergic acid diethylamide, and lysergic acid amide, were comparable to or more efficacious than most conventional medications. These agents were also perceived to shorten/abort a cluster period and bring chronic cluster headache into remission more so than conventional medications. Furthermore, infrequent and non-hallucinogenic doses were reported to be efficacious. Findings provide additional evidence that several indoleamine hallucinogens are rated as effective in treating cluster headache. These data reinforce the need for further investigation of the effects of these and related compounds in cluster headache under experimentally controlled settings.

Survey Analysis of the Use, Effectiveness, and Patient‐Reported Tolerability of Inhaled Oxygen Compared With Injectable Sumatriptan for the Acute Treatment of Cluster Headache

“…General demographic and headache characteristic data for the Clusterbusters ® Medication Use survey were previously published and were generally consistent with those reported in the literature . The pool of participants for the current analysis does not include participants under age 21, which does not significantly change these findings.…”

“…The Clusterbusters ® Medication Use survey was created and carried out by Clusterbusters ® , Incorporated, a non‐profit organization based in Illinois dedicated to the education and research of cluster headache. Methodology behind this survey is reported elsewhere . In short, the survey was open from May 2, 2012 to July 11, 2012 and was advertised at clusterheadache.com, cluster headache sites on Facebook © , and the headache clinics listed at migraines.org.…”

Clinical applications of hallucinogens: A review.

“…The most common adverse side effect of psilocybin was found to be mild and well-tolerated headache (e.g., Johnson et al, 2012), and lethargy immediately after psilocybin administration with normal function largely restored after 24 hours. Interestingly, psilocybin and LSD have been implicated as potential treatments for cluster headache, a highly debilitating pain syndrome; however, most data in this area remain anecdotal in nature, and controlled studies are necessary to assess efficacy (Schindler et al, 2015; Sewell et al, 2006). …”

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

“…Available data highlight a lifetime use of psychedelics (including mescaline, LSD and derivatives, dimethyltryptamine [DMT], psilocybin [“hallucinogenic mushrooms”]) and dissociative anesthetic (ketamine) that is significantly higher in CH patients than the general population, for both genders . To date, published studies involving questionnaire‐based surveys among CH patients (500 participants) and an open case series of 5 patients suggest a positive effect of LSD, LSA, 2‐bromo‐lysergic acid diethylamide (BOL), and psilocybin on CH . Controlled studies are required to confirm efficacy, effective dose, and safety.…”