Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study

Abstract

Background: Medical cannabis (MC) treatment for migraine is practically emerging, although sufficient clinical data are not available for this indication. This cross-sectional questionnaire-based study aimed to investigate the associations between phytocannabinoid treatment and migraine frequency. Methods: Participants were migraine patients licensed for MC treatment. Data included self-reported questionnaires and MC treatment features. Patients were retrospectively classified as responders vs. non-responders (≥50% vs. <50% decrease in monthly migraine attacks frequency following MC treatment initiation, respectively). Comparative statistics evaluated differences between these two subgroups. Results: A total of 145 patients (97 females, 67%) with a median MC treatment duration of three years were analyzed. Compared to non-responders, responders (n = 89, 61%) reported lower current migraine disability and lower negative impact, and lower rates of opioid and triptan consumption. Subgroup analysis demonstrated that responders consumed higher doses of the phytocannabinoid ms_373_15c and lower doses of the phytocannabinoid ms_331_18d (3.40 95% CI (1.10 to 12.00); p < 0.01 and 0.22 95% CI (0.05–0.72); p < 0.05, respectively). Conclusions: These findings indicate that MC results in long-term reduction of migraine frequency in >60% of treated patients and is associated with less disability and lower antimigraine medication intake. They also point to the MC composition, which may be potentially efficacious in migraine patients.

Medical Cannabis, Headaches, and Migraines: A Review of the Current Literature

“…Several studies have reported both the benefits and effectiveness of medical cannabis use. A prospective clinical trial done in 2020 by Aviram et al focused on 68 patients who smoked or vaped MC inflorescences evaluated the differences in total MC monthly dose between responders and non‐responders [ 17 ]. This study focused on the associations between phytocannabinoid treatment and migraine frequency [ 17 ].…”

“…A prospective clinical trial done in 2020 by Aviram et al focused on 68 patients who smoked or vaped MC inflorescences evaluated the differences in total MC monthly dose between responders and non‐responders [ 17 ]. This study focused on the associations between phytocannabinoid treatment and migraine frequency [ 17 ]. The study also reported better migraine symptom reduction, less negative headache impact, better sleep quality, and decreased medication consumption [ 17 ].…”

“…This study focused on the associations between phytocannabinoid treatment and migraine frequency [ 17 ]. The study also reported better migraine symptom reduction, less negative headache impact, better sleep quality, and decreased medication consumption [ 17 ]. In 2019, Cuttler et al, in their survey study from a Canadian data application (Strainprint), focused on the inhaled cannabis usage and their effect of reduction in migraine severity and frequency along with the factors affecting the dosage used [ 19 ].…”

“…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.…”

Cannabis: Neuropsychiatry and Its Effects on Brain and Behavior

“…Based on treatment response, indexed as a decrease in monthly migraine attacks frequency ≥50%, authors were able to identify a specific strain with potential benefits, containing higher doses of the phytocannabinoid ms_373_15c and lower doses of the phytocannabinoid ms_331_18d. As stated by the authors themselves, the anti-migraine effect of such phytocannabinoids and whether they are biological active will have to be elucidated in future studies [ 22 ]. This Special Issue also hosts the study protocol of a randomized controlled trial aiming to evaluate the efficacy of adjunctive dronabinol (licensed form of ∆9-THC) at the doses of 5 to 30 mg/die versus control (systemic analgesics only) for reducing opioid consumption in adults aged 18–65 years with traumatic injury [ 23 ].…”