Medical Cannabis for the Treatment of Migraine in Adults: A Review of the Evidence

Abstract

BackgroundMedical cannabis (MC) has been hypothesized as an alternative therapy for migraines, given the undesirable side effects of current migraine medications. The objective of this review was to assess the effectiveness and safety of MC in the treatment of migraine in adults.MethodsWe searched PubMed, EMBASE, PsycINFO, CINAHL, and Web of Science for eligible studies in adults aged 18 years and older. Two reviewers independently screened studies for eligibility. A narrative synthesis of the included studies was conducted.ResultsA total of 12 publications involving 1,980 participants in Italy and the United States of America were included.Medical cannabis significantly reduced nausea and vomiting associated with migraine attacks after 6 months of use. Also, MC reduced the number of days of migraine after 30 days, and the frequency of migraine headaches per month. MC was 51% more effective in reducing migraines than non-cannabis products. Compared to amitriptyline, MC aborted migraine headaches in some (11.6%) users and reduced migraine frequency. While the use of MC for migraines was associated with the occurrence of medication overuse headaches (MOH), and the adverse events were mostly mild and occurred in 43.75% of patients who used oral cannabinoid preparations.ConclusionsThere is promising evidence that MC may have a beneficial effect on the onset and duration of migraine headaches in adults. However, well-designed experimental studies that assess MC's effectiveness and safety for treating migraine in adults are needed to support this hypothesis.

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

“…After the detailed assessment, and applying inclusion/exclusion criteria, we ended up with 123 articles and excluded 1531 articles. In the end, only nine articles were included, and these articles were checked for quality based on their study characteristics [1,5,8,10,[12][13][14][15][16]. A complete PRISMA flow diagram is given below in Figure 2.…”

“…The study by Okusanya et al in 2022 included a total of 12 publications involving 1,980 participants from Italy and the United States of America [ 15 ]. In their studies, they concluded that medical cannabis decreased the number of days with a migraine after 30 days as well as the monthly frequency of migraine headaches [ 15 ]. Medical cannabis was 51% more effective than non-cannabis drugs for reducing migraines [ 15 ].…”

“…In their studies, they concluded that medical cannabis decreased the number of days with a migraine after 30 days as well as the monthly frequency of migraine headaches [ 15 ]. Medical cannabis was 51% more effective than non-cannabis drugs for reducing migraines [ 15 ]. When compared to amitriptyline, medical cannabis reduced the frequency of migraine attacks and prevented migraine headaches in certain users (11.6%) [ 15 ].…”

“…Medical cannabis was 51% more effective than non-cannabis drugs for reducing migraines [ 15 ]. When compared to amitriptyline, medical cannabis reduced the frequency of migraine attacks and prevented migraine headaches in certain users (11.6%) [ 15 ]. After six months of therapy, medical cannabis also considerably decreased nausea and vomiting brought on by migraine attacks [ 15 ].…”

“…In the study by Okunsanya et al in 2022, they found mainly mild side effects in 43.75% of patients who used oral cannabinoid preparation [ 15 ]. Additionally, they reported that a large rise in dose over time for each cannabis usage session indicates medical cannabis tolerance and might lead to the use of a greater dosage of medical cannabis [ 15 ]. Medical cannabis for migraines has also been linked to medication overuse headaches (MOH) compared with non-cannabis users (81% vs 41%) [ 15 ].…”