humulene and Migraine-Disorders

There is increasing interest in the use of cannabis and cannabinoid therapies (CCT) by the general population and among people with headache disorders, which results in a need for healthcare professionals to be well versed with the efficacy and safety data. In this manuscript, we review cannabis and cannabinoid terminology, the endocannabinoid system and its role in the central nervous system (CNS), the data on efficacy, safety, tolerability, and potential pitfalls associated with use in people with migraine and headache disorders. We also propose possible mechanisms of action in headache disorders and debunk commonly held myths about its use.. Preliminary studies show that CCT have evidence for the management of migraine. While this evidence exists, further randomized, controlled studies are needed to better support its clinical use. CCT can be considered an integrative treatment added to mainstream medicine for people with migraine who are refractory to treatment and/or exhibit disability and/or interest in trying these therapies. Further studies are warranted to specify appropriate formulation, dosage, and indication(s). Although not included in guidelines or the AHS 2021 Consensus Statement on migraine therapies, with the legalization of CCT for medical or unrestricted use across the USA, recent systematic reviews highlighting the preliminary evidence for its use in migraine, it is vital for clinicians to be well versed in the efficacy, safety, and clinical considerations for their use. This review provides information which can help people with migraine and clinicians who care for them make mutual, well-informed decisions on the use of cannabis and cannabinoid therapies for migraine based on the existing data.

Topics: Cannabinoid Receptor Agonists; Cannabinoids; Cannabis; Humans; Medical Marijuana; Midazolam; Migraine Disorders

The use of cannabis for the treatment of migraine has become an area of interest with the legalization of medical cannabis in the USA. Understanding the mechanisms of cannabinoids, available studies, and best clinical recommendations is crucial for headache providers to best serve patients.. Patients utilizing medical cannabis for migraine have reported improvement in migraine profile and common comorbidities. Reduction in prescription medication is also common, especially opioids. Side effects exist, with the majority being mild. Not enough data is available for specific dose recommendations, but THC and CBD appear to mediate these observed effects. The purpose of this article is twofold: review the limited research surrounding cannabis for migraine disease and reflect on clinical management experiences to provide recommendations that best capture the potential use of cannabis for migraine.

Topics: Analgesics; Animals; Cannabis; Dose-Response Relationship, Drug; Drug Administration Routes; Drug Evaluation, Preclinical; Humans; Medical Marijuana; Migraine Disorders

Migraine is a disabling neurovascular disorder with few targeted, tolerable and effective treatments. Phytomedicines, or plant-based medicinal formulations, hold great promise in the identification of novel therapeutic targets in migraine. Many patients also turn toward herbal and plant-based therapies for the treatment of their migraines as clinical and preclinical evidence of efficacy increases. Patients seek effective and tolerable treatments instead of or in addition to current conventional pharmacologic therapies. We review some phytomedicines potentially useful for migraine treatment-feverfew (Tanacetum parthenium), butterbur (Petasites hybridus), marijuana (Cannabis spp.), Saint John's Wort (Hypericum perforatum) and the Damask rose (Rosa × damascena)-with respect to their mechanisms of action and evidence for treatment of migraine. The evidence for feverfew is mixed; butterbur is effective with potential risks of hepatotoxicity related to preparation; marijuana has not been shown to be effective in migraine treatment, and data are scant; Saint John's Wort shows relevant physiological activity but is a hepatic enzyme inducer and lacks clinical studies for this purpose; the Damask rose when used in topical preparations did not show efficacy in one clinical trial. Other plant preparations have been considered for migraine treatment but most without blinded randomized, placebo-controlled trial evidence.

Topics: Cannabis; Humans; Hypericum; Migraine Disorders; Petasites; Phytotherapy; Plant Preparations; Plants, Medicinal; Tanacetum parthenium

Review the medical literature for the use of cannabis/cannabinoids in the treatment of migraine, headache, facial pain, and other chronic pain syndromes, and for supporting evidence of a potential role in combatting the opioid epidemic. Review the medical literature involving major and minor cannabinoids, primary and secondary terpenes, and flavonoids that underlie the synergistic entourage effects of cannabis. Summarize the individual medicinal benefits of these substances, including analgesic and anti-inflammatory properties.. There is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain-specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease-targeted therapies.

Topics: Cannabinoids; Cannabis; Flavonoids; Headache; Humans; Migraine Disorders; Pain; Terpenes

Ethan B. Russo's paper of December 1, 2003 explored the concept of a clinical endocannabinoid deficiency (CECD) underlying the pathophysiology of migraine, fibromyalgia, irritable bowel syndrome and other functional conditions alleviated by clinical cannabis.. Available literature was reviewed, including searches via the National Library of medicine database and other sources.. A review of the literature indicates that significant progress has been made since Dr. Ethan B. Russo's landmark paper, just ten years ago (February 2, 2004). Investigation at that time suggested that cannabinoids can block spinal, peripheral and gastrointestional mechanisms that promote pain in headache, fibromyalgia, irritable bowel syndrome and muscle spasm.. Subsequent research has confirmed that underlying endocannabinoid deficiencies indeed play a role in migraine, fibromyalgia, irritable bowel syndrome and a growing list of other medical conditions. Clinical experience is bearing this out. Further research and especially, clinical trials will further demonstrate the usefulness of medical cannabis. As legal barriers fall and scientific bias fades this will become more apparent.

Topics: Analgesics; Animals; Cannabis; Drug Resistance; Endocannabinoids; Fatigue Syndrome, Chronic; Fibromyalgia; Humans; Irritable Bowel Syndrome; Lipid Metabolism, Inborn Errors; Medical Marijuana; Migraine Disorders; Nervous System Diseases

Topics: Anorexia; Cachexia; Cannabinoids; Cannabis; Epilepsy; Hiccup; Humans; Migraine Disorders; Muscle Spasticity; Nausea; Pain; Palliative Care; Randomized Controlled Trials as Topic; Seizures; Vomiting

Cannabis, or Marijuana, has been used for centuries for both symptomatic and prophylactic treatment of migraine. It was highly esteemed as a headache remedy by the most prominent physicians of the age between 1874 and 1942, remaining part of the Western pharmacopoeia for this indication even into the mid-twentieth century. Current ethnobotanical and anecdotal references continue to refer to its efficacy for this malady, while biochemical studies of THC and anandamide have provided a scientific basis for such treatment. The author believes that controlled clinical trials of Cannabis in acute migraine treatment are warranted.

Topics: Cannabis; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Migraine Disorders; Phytotherapy

Cyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction (DGBI) characterized by recurrent episodes of nausea and vomiting. Most children outgrow their CVS symptoms and develop migraine headaches, but there are limited data in adults. We thus sought to determine the natural history of CVS in adults.. We conducted a retrospective analysis of patients at a specialized tertiary care clinic. Frequency of CVS episodes, emergency department (ED) visits, and hospitalizations were recorded at the index visit and at follow-up.. Of 455 CVS patients with complete data, mean age was 33 ± 13 years, 294 (65%) were female, and 392 (86%) were Caucasian. Mean duration of follow-up was 47.4 ± 37.2 months. There was a significant reduction in frequency of CVS episodes/year (18 to 6.8), ED visits (6.1 to 2), and hospitalizations (2.3 to 0.7) (all p-values < 0.001) but only 88 (19%) of patients had complete resolution of episodes at follow-up. On multivariable regression analysis, non-white race [0.33 (0.11-0.98) p = 0.01], comorbidity count [0.77 (0.62-0.95) p = 0.01], cannabis use [0.36 (0.2-0.65) p = 0.0007], and aprepitant use [0.2 (0.08-0.005) p < 0.001] were associated with a reduced odds of complete resolution of CVS episodes. Of note, 19 patients (4%) died.. While most adults with CVS improved with specialized care, in contrast to children, only a small subset (~1 in 5) had complete resolution of symptoms. Reasons for the effects of race, cannabis use, and comorbidity burden on outcomes in CVS are unclear and warrant further investigation.

Topics: Adult; Cannabis; Child; Female; Humans; Male; Middle Aged; Migraine Disorders; Retrospective Studies; Tertiary Care Centers; Vomiting; Young Adult

In psychiatry, routine EEGs are often abnormal and not very specific, raising questions about the clinical relevance and consequences of potential anomalies. One such question is whether the administration of anticonvulsants would be useful if epileptic discharges are detected in patients without any clinical correlates. With regard to this question, we present a case study in which abnormal EEG patterns were observed in a patient with chronic migraine and cannabis addiction. The patient was a 34-year-old woman with a 14-year history of cannabis abuse who, during withdrawal, showed epileptic spikes, without any corresponding clinical symptoms, and migraine attacks of increasing intensity and frequency. This case study is in line with the new

Topics: Adult; Anticonvulsants; Brain; Cannabis; Electroencephalography; Epilepsy; Female; Humans; Migraine Disorders; Substance Withdrawal Syndrome

Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.. Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0-10 scale prior to, and immediately, following Cannabis consumption.. Ninety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0-10 scale (standard deviation = 2.28, Cohen's d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as "C. indica" rather than "C. sativa" or other hybrid strains.. These results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.

Topics: Cannabis; Dronabinol; Female; Flowers; Headache; Humans; Male; Migraine Disorders; Plant Preparations; United States

Topics: Amyloid Neuropathies, Familial; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Biosimilar Pharmaceuticals; Biotechnology; Cannabis; Drug Approval; Humans; Migraine Disorders; Neoplasms; Orphan Drug Production; Pyrazoles; Pyrimidines; RNA Interference; United States; United States Food and Drug Administration

Cannabis has been used for centuries in the treatment of medical conditions. Cannabis has been recommended for appetite, anxiety, depression, sleep, and migraines. However, the stigma associated with cannabis as a recreational drug has created challenges to the legitimacy and social acceptance of cannabis for medical purposes in the United States.

Topics: Anxiety; Appetite; Cannabis; Depression; Guidelines as Topic; Humans; Migraine Disorders; Sleep; United States

Topics: Acupuncture Therapy; Analgesics; Analgesics, Opioid; Cannabis; Cognitive Behavioral Therapy; Complementary Therapies; Headache; Humans; Manipulation, Chiropractic; Massage; Migraine Disorders; Muscle Relaxants, Central; Pain; Pain Management; Physical Therapy Modalities

Topics: Adult; Cannabis; Emergency Medicine; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Illicit Drugs; Intraocular Pressure; Migraine Disorders; N-Methyl-3,4-methylenedioxyamphetamine; Ophthalmology; Substance-Related Disorders; Treatment Outcome; Visual Acuity

A number of clinical reports have revealed an association between the use of alcohol and drugs and the onset or exacerbation of headaches. In order to investigate this association systematically and to examine the temporal relationship between onset of headaches and psychoactive substance use, we analyzed responses to a self-report questionnaire from 267 consecutive admissions to a three-week inpatient substance abuse treatment program. The response rate was 89.7%. The following characteristics were noted in the 236 respondents: 1) Over 89% reported having experienced some type of headache. 2) Headache-free individuals were significantly older than headache sufferers. 3) Women were much more likely to have migraine headaches than men. 4) Onset of migraines occurred prior to onset of substance use, while onset of tension headaches occurred after onset of substance use. Although associational data must be interpreted with caution, an intriguing hypothesis compatible with the finding is that migraines may play a role in the genesis of substance use, while substance use may play a role in the genesis of tension headaches.

Topics: Adult; Cannabis; Cocaine; Ethanol; Female; Headache; Humans; Incidence; Male; Middle Aged; Migraine Disorders; Muscle Contraction; Psychotropic Drugs; Substance-Related Disorders; Surveys and Questionnaires

Topics: Adult; Aged; Cannabis; Cocaine; Female; Humans; Male; Middle Aged; Migraine Disorders; Substance-Related Disorders; Surveys and Questionnaires

Topics: Adolescent; Adult; Alanine Transaminase; Aspartate Aminotransferases; Bronchitis; Cannabis; Chemical and Drug Induced Liver Injury; Colic; Drug Hypersensitivity; Female; Gingivitis; Humans; Laryngitis; Liver Diseases; Male; Migraine Disorders; Otitis; Pharyngitis; Respiratory Tract Diseases; Sinusitis; Stomatitis; Substance-Related Disorders; Vascular Diseases