Migraines can be profoundly debilitating, with migraineurs often experiencing additional troubling symptoms such as nausea and over-sensitization to light. An estimated 14.7 percent of individuals globally suffer from migraines. In the U.S., head pain is the fifth-leading cause of emergency room visits.
Current research indicates that migraines occur when pain signal processing is lowered in response to inflammatory agents. Environmental and hormonal triggers most likely initiate the onset of a migraine. Anti-migraine medication often provokes adverse effects, which has resulted in a reduction of research into anti-migraine drugs.
Given this context, many migraineurs are receptive to new treatments that promise to help manage migraine pain. Cannabidiol (CBD) oil has recently captured the attention of scientists and sufferers alike. CBD’s analgesic effects, anti-inflammatory properties, and anti-emetic qualities may help relieve the pain and nausea associated with the condition.
While there are still no clinical studies exploring the efficacy of CBD oil as a treatment for migraines, several scholarly reviews and studies point to the importance of modulating the endocannabinoid system (ECS) and the use of cannabinoids such as CBD as a potential therapy.
Endocannabinoid receptors are found in the pain processing areas of the brain. “Anandamide (an endocannabinoid) has been shown to target some of the same signaling pathways as triptans, a class of medications primarily used in the treatment of migraines and cluster headaches. This supports the therapeutic potential of cannabinoids in the treatment of migraine,” explained Rosalia Yoon, a cannabis research scientist for Toronto-based Apollo Cannabis Clinics, which advises patients and conducts studies on medical marijuana.
A review published in the June 2019 issue of Current Opinion in Neurology suggests that CBD may have a role to play in alleviating the pain associated with migraines. CBD can affect the function and activity of signaling pathways by targeting the serotonin 1A and TRPV1 receptors that play a role in pain control.
The review also points out that CBD can suppress the release of cytokines and chemokines, which are linked to inflammatory pain, and modulate the immune cell system. The modulation of the ECS with cannabinoids could offer a tolerable and pharmacologically sound treatment for migraines; however, the study’s authors expressed the need for further studies to explore the mechanisms by which this occurs.
Another review published in the July 2016 issue of Cannabis and Cannabinoid Research proposed the idea that migraines may be caused, in part, by a deficiency in the ECS, which could result in an increased sensitivity to pain and stimuli. The increased sensitivity to light and noise that often accompanies migraines suggests a homeostatic imbalance in the body that a normally functioning endocannabinoid system tends to correct.
There is clinical evidence that suggests this hypothesis could hold validity. A study published in June 2007 in the journal Neuropsychopharmacology showed evidence of depressed anandamide (AEA) levels in the cerebrospinal fluid of migraine sufferers. Low AEA levels are a possible indication of an impaired ECS. These findings point to cannabinoids as a potential therapy for chronic migraine sufferers.
According to Dr. Ethan Russo, author of the study in Cannabis and Cannabinoid Research, further studies utilizing standardized preparations with low THC and higher titers of CBD in randomized controlled trials are long overdue. There is already preclinical evidence that THC can ameliorate migraine pain, according to the European Journal of Pharmacology.
Shelly Schneider, 39, is the president of a busy CBD e-commerce store and a mother. She first began to experience migraines while she was in college in 2003, which she attributes as resulting from ongoing stress and tension.
“When I get a migraine, it takes me out for the day. I need a heat pad and a dark, quiet room. Then I need to sleep it off. It makes me nauseated and makes my entire head throb, she said”
Schneider had traditionally relied on Tylenol to help manage her migraines. She began taking CBD oil for cholesterol but realized it was also alleviating her migraines. “When I realized it was also helping with my migraines, I was sold,” she told Weedmaps News.
Schneider said CBD oil also helps with migraine prevention. “Since CBD has anti-inflammatory properties, it helps with the tension and prevents the migraines from getting as bad if I do get one. They are also much less frequent.”
Schneider notes that her anxiety has diminished, and endometriosis pain is improved, benefits she also attributes to CBD oil.
What the Experts Say
Dr. Stephen Silberstein, Director of the Jefferson Headache Center in Philadelphia, recommends CBD oil for his migraine patients. Among its benefits, Silberstein points out that it is non-intoxicating, non-sedating, reduces anxiety, and doesn’t reinforce cravings or compulsive use.
“We use CBD topically in the area of the neck with good results. We’re uncertain as to the benefit of CBD taken orally for migraines, however.” This may be because CBD ingested orally has limited bioavailability.
Dr. Steven Zodkoy, a medical consultant at Monmouth Advanced Medicine, a New Jersey chiropractic clinic, noted that his chronic migraine patients use CBD in a preventative capacity. Zodkoy said that CBD helps to mediate their overall stress level, which is helpful as migraine patients often become fearful of triggering an episode. “Physiologically, CBD has a relaxing effect on the body which makes it more pliable to adjust to stress. I have been using full spectrum hemp products/CBD with my migraine patients for a few years with excellent results.”
According to Dr. Paula Williams, a physician at Apollo Cannabis Clinics, migraineurs may find it useful to try CBD themselves to see how it compares to first-line medications.
“There is already a great deal of patient experience with CBD, and there are a few studies that suggest that CBD and cannabis are at least as good as common migraine preventive medications, without the side effects,” Williams said. She points out that CBD oil can be used as a preventative measure or acute treatment.
Williams also emphasizes that first-line migraine medications such as Imitrex and Maxalt can be used with CBD, as can new migraine medication Aimovig. “They will not interact. CBD is not yet known to have major drug interactions.”
The Bottom Line
More research is needed to determine the efficacy of CBD oil as a treatment for migraines, and develop recommendations regarding dosage. “Randomized controlled trials are needed to better evaluate the benefits of cannabinoids such as CBD, including their effects on pain, and treatment guidelines in clinical practice,” Yoon said.
But in the meantime, reviews and anecdotal experience suggest that CBD for migraines holds promise.