Cannabinoids show promise in acute migraine clinical trial

inhaled cannabinoids
Giancarlo Revolledo

Inhaled cannabinoids have been shown to perform better than placebo in providing pain relief for people suffering from acute migraine, according to a new clinical trial.

In the study, researchers compared standardised formulations of tetrahydrocannabinol and/or cannabidiol (CBD) – at various strengths and delivered using a vaporiser – to placebo in adult subjects over four migraine attacks.

A preprint of the 92-patient study – which has not yet been subjected to peer review – reveals that a combination of 6% THC and 11% CBD performed the best and was able to provide a significant improvement on the main endpoint of pain relief two hours after a migraine attack.

The team from the University of California at San Diego (UCSD) Health System also report in the paper that the formulation also outperformed placebo on two-hour pain freedom and relief of the most bothersome symptoms (MBS), and were sustained for 24 to 48 hours. Subjects recorded the results using a smartphone application.

Along with pain, migraineurs often complain of other debilitating symptoms, including sensitivity to light and sound and nausea/vomiting. The cannabinoid combination was able to reduce the light and sound sensitivity at two and 24 hours, but had no effect on nausea and vomiting, according to the researchers.

They note that, while migraine sufferers often ask healthcare professionals about the potential of cannabinoids in managing migraine, there has been a lack of data to support their use and, to their knowledge, this is the first prospective, randomised clinical trial (RCT) of standardised potencies.

An earlier meta-analysis published in 2022 pointed to a significant clinical response for medical cannabis in reducing the length and frequency of migraines and recommended additional clinical trials to study safety and efficacy.

The authors note that the THC potencies under test were lower than would typically be seen in cannabis acquired from US dispensaries and less likely to cause a high, “bolstering evidence that higher potencies and titrating to highness are unnecessary for medicinal benefit.”

“More research is needed to evaluate repeated administrations and regular, long-term use of cannabinoids for migraine,” they conclude.

Migraine is the second leading cause of years lived with disability worldwide, and affects over a billion people worldwide, including 38 million Americans, according to data from the Global Burden of Disease Study 2019. Currently, cannabis is legal in 38 of 50 US states for medical use and 24 states for recreational use.

Photo by Giancarlo Revolledo on Unsplash