What are migraines?
Studies show that migraines affect over 3 million Australians and are the most common disabling brain disorder. Migraines are frequently categorised by intense and/or debilitating headaches and are often genetic. Migraines can begin in childhood or any stage of life and seem to be suffered by women more frequently due to hormonal factors. People can experience migraines sporadically and for short periods of time, or they can experience chronic migraines. Chronic migraines are categorised by experience of intense, debilitating headaches for at least 15 days of the month.
What are the symptoms of migraines?
Migraines have multiple symptoms and are often experienced within different stages of a migraine episode. Individuals who suffer from migraines may experience all stages of a migraine episode or only some.
Migraine symptoms can sometimes occur days before the attack, and this occurrence has been named the prodrome stage. Symptoms within this stage often include;
- Low energy
- Food cravings
- Neck stiffness
The secondary stage of a migraine episode is named the aura stage. This stage involves nervous system and/or visual disturbances and symptoms can include;
- Difficulty speaking clearly
- Temporary loss of vision
- Seeing flashes of lights or shapes
- Hearing noises or music
- Tingling sensations in the body
- Weakness or numbness in the body
The next stage is referred to as the attack stage and this is when the actual migraine pain occurs. Symptoms within the attack phase can last from anywhere between hours or days, and often include;
- Pulsing and throbbing head pain
- Nausea and/or vomiting
- Increased sensitivity to light
- Concentrated pain on one side of the head
- Feeling faint
After the attack phase has subsided, people often enter the post-drome phase. This phase involves changes in mood such as feeling drained, tired or euphoric and a lingering dull headache.
What causes migraines?
There is still some mystery surrounding what causes migraines, as medical researchers are yet to discover any solid foundations. Possible causes have been identified, though nothing definitive. The most popular and solid possible cause of migraines revolves around genetics and inheritance of the illness, however, the genetic basis of migraines are complex, and it is still uncertain which genes may be involved within the inheritance. Another possible cause of migraines includes trigger factors, such as certain food additives (MSG, nitrates), high-stress levels and anxiety, caffeine, weather changes, sleep disturbances, bright lights, loud sounds, strong odours and the menstrual cycle. Other causes may include abnormalities of brain chemicals and nerve pathways, an underlying central nervous disorder and irregularities in the brain’s blood vessel system or vascular system.
Traditional treatments for migraines
Doctors can help patients manage their migraines so that they occur less frequently and less severely. There are numerous treatments for migraines, and an individual’s treatment plan will often depend on their age, their symptoms, the type of migraines they experience and how much they impact their everyday life. Treatments for migraines include abortive therapy; where the migraine is stopped in its tracks and prophylactic therapy; which aims to reduce the frequency and/or severity of migraines.
Patients with mild to moderate headaches and no nausea and/or vomiting and often referred to take standard pain medications such as ibuprofen or paracetamol, however, when the symptoms are more severe; prescription medications are opted for. Prescription medication used to alleviate pain includes NSAIDs (nonsteroidal anti-inflammatory drugs) and narcotics such as codeine. Whilst these medications do provide relief for patients, they are often paired with many negative side effects. NSAIDs can actually make headaches more severe if they are used every day, and other side effects include tiredness, flushing, throat and chest tightening, depression, nausea, insomnia, weight changes, impotence and digestive issues.
Medicinal CBD for migraines
In ancient India (2500 BC), cannabis was a major element in religious and medicinal practices. Texts that survived from this time suggest that cannabis’ psychoactive properties were significantly recognised and doctors used it as a treatment for many medical issues, including migraines and headaches. More recently, a growing body of research suggests that medicinal CBD may help to relieve pain, with a focus on neurological pain linked with many illnesses and conditions. Various research has been able to link medical cannabis to the alleviation of pain, nausea and inflammation which are all key aspects of migraine episodes whilst also exhibiting little to no side effects.
A study published by NCBI explored the Emerging Role of (Endo)Cannabinoids in Migraine by examining and summarizing recent discoveries and contemporary hypotheses in regards to ‘cannabinoids in controlling trigeminal nociceptive system underlying migraine pain.’ The study examined existing research material drawn from standard searches of the PubMed/National Libray of Medicine database, influential sources of current medical literature and past review articles. The articles selected for examination were based on historical, clinical or preclinical relevance to cannabinoids as a treatment for headaches. Through the examination of this various research, the study found that medicinal CBD is certainly a promising treatment for a broad range of migraine symptoms. This is due to cannabinoids having ‘anticonvulsive, analgesic, antiemetic, and anti-inflammatory effects’ and the abundance of CB1 receptors in the brain that respond to cannabinoids and are linked to migraines.
Similarly, another study published in 2019 on The Journal of Pain examined and analysed archival data – though, this data was from the Strainprint app. The Strainprint app allowed its users to track migraine symptoms before and after using medical cannabis, which was purchased through Canadian producers and distributors. The app collected data from more than 1300 patients who used the app over 12200 times to track symptoms and changes in headaches, before and after cannabis use. Through the collection and analysis of the data, the study ultimately found that ‘inhaled cannabis reduces self-reported headache severity by 47.3% and migraine severity by 49.6%.’ Additionally, the study found that there was a small gender difference within the results, with more headache reduction reported by males (90%), than by women (89.1%) – though there are no other results that would suggest a reason as to why this occurred. Researchers involved in the study also noted that cannabis concentrates such as cannabis oil, were more effective in reducing migraine severity when compared to the cannabis flower, and that there was no reported difference in pain reduction among strains that were higher in either THC or CBD. In contrast to some existing traditional medications for the treatment of migraines, this research also suggested that there was no evidence that overuse of cannabis caused further headaches, as it does with the use of NSAIDs. Through analysing the data, researchers did observe that patients were using larger doses of cannabis over time, which may suggest a growing tolerance to the drug.
Does CBD help with migraines?
There has been much debate surrounding medicinal CBD as a treatment for migraines across the globe, and at the 3rd Congress of the European Academy of Neurology (EAN), a group of researchers presented the results of their study on cannabinoids and migraine prevention. The study was conducted in Italy in 2017 and covered both chronic migraine and cluster headache patients. The ultimate aim of the study was to discover what amount of CBD proves efficacy in reducing the symptoms of migraines and headaches, and an initial dose of 10 mg was given orally to patients who suffered chronic migraines. The dose contained two compounds, THC and CBD and through multiple stages and iterations of the administration of CBD, the team found that doses under 100 mg did not have any effect on symptoms, however, a dose of 200 mg resulted in a 55 per cent drop in acute pain. Overall, the study found that cannabinoids were effective in migraine patients – with reducing pain by 43.5 per cent collectively.
Though many studies demonstrate that medicinal CBD is certainly effective in treating the symptoms of migraines, it is not yet known if CBD could reduce or eliminate the frequency of migraines. Additionally, most of the contemporary research regarding medicinal CBD as a treatment for migraines centres around self-reporting and drawing conclusions from existing research, thus, there is not enough sufficient evidence from adequate clinical trials to objectively support the use of cannabis as a cure for headaches. However, there is ‘sufficient anecdotal and preliminary results as well as plausible neurobiological mechanisms’ that highlight and warrant the need for well designed future clinical trials in order for medical professionals to comprehensively understand the connection between the reduction of migraine symptoms through the use of cannabinoids.