Cannabinoids and Hallucinogens for Headache

Brian E. McGeeney, MD, MPH

Disclosures

Headache. 2013;53(3):447-458. 

In This Article

Conclusions

Cannabinoids enjoyed considerable prominence in the early medical pharmacopeia, advocated by top physicians of the time, and continue to be used by patients for relief of headache generally without physician recommendation. There is much anecdotal support and experimental evidence for this use but no good clinical trials for headache. The actions of cannabinoids, including the analgesic activity on the trigeminal nucleus caudalis, presynaptic inhibition of glutamate release, an anti-inflammatory effect, anti-emetic effect, and vasoconstrictive effect appear to make cannabinoids a good migraine treatment, albeit with health concerns in connection with smoking and overuse. Progressive state legislature support for medical marijuana is making this option somewhat easier for health care professionals, but remains federally prohibited. Ergotamine-related hallucinogen use has become popular among some cluster headache sufferers, again with anecdotal but compelling success in relieving headache along with a credible biological rationale. Deficits in medical therapy in particular have led to self-treatment with cannabinoids and hallucinogens to become increasingly popular, notwithstanding the habit forming potential in certain individuals. The future may bring therapeutic options based on these treatments, with new research and clinical study.

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