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Migraine Frequency Decreased by Medical Marijuana

Patients diagnosed with migraine headaches saw a significant drop in their frequency when treated with medical marijuana, according to a new study from researchers at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado Anschutz Medical Campus.

The study, published this week in the journal Pharmacotherapy, examined patients diagnosed with migraines and treated with medical marijuana between Jan. 2010 and Sept. 2014. It found the frequency of migraines dropped from 10.4 to 4.6 headaches per month, a number considered statistically and clinically significant.

Of the 121 patients studied, 103 reported a decrease in monthly migraines while 15 reported the same number and three saw an increase in migraines.

“There was a substantial improvement for patients in their ability to function and feel better,” said the study’s senior author Professor Laura Borgelt, PharmD, FCCP, BCPS. “Like any drug, marijuana has potential benefits and potential risks. It’s important for people to be aware that using medical marijuana can also have adverse effects.”

The study looked at the charts of patients treated at Gedde Whole Health, a private medical practice in Colorado that specializes in recommending marijuana for a variety of conditions. About a two-thirds of the patients studied had a history of or were currently using cannabis at the time of their initial visit.

The researchers found various forms of cannabis utilized. Inhaled marijuana appeared to be the favorite for treating acute migraines while edible cannabis, which takes longer to impact the body, helped prevent headaches.

But exactly how cannabis relieves migraines is still not fully understood.

Borgelt said cannabinoid receptors can be found throughout the body, including the brain, connective tissues and immune system. And they appear to have anti-inflammatory and pain-relieving properties. These cannabinoids also seem to affect critical neurotransmitters like serotonin and dopamine.

“We believe serotonin plays a role in migraine headaches, but we are still working to discover the exact role of cannabinoids in this condition,” Borgelt said.

Image shows a medical marijuana shop sign with a picture of a brain over the top.

The researchers found various forms of cannabis utilized. Inhaled marijuana appeared to be the favorite for treating acute migraines while edible cannabis, which takes longer to impact the body, helped prevent headaches. Image is for illustrative purposes only.

The study is one of the first to reveal a drop in migraine frequency due to medical marijuana.

Borgelt said the results were `quite remarkable’ but stressed the need for more controlled studies in the future.

The ideal study, she said, would be a randomized, placebo-controlled clinical trial with a marijuana washout period prior to start. It would also require providing subjects with standardized quantities and potencies of medical marijuana while tracking the occurrence of migraines just like prescription drug studies. But given federal anti-drug laws, that kind of study would likely require legislative changes before it could be done, Borgelt said.

“If patients are considering medical marijuana they should speak to their health care provider and then follow up so we can track the impact of their overall treatment,” Borgelt said. “Open communication is necessary because we need to know how all of these treatments work together.”

About this neurology research

The other study authors include Danielle Rhyne, PharmD, BCPS and Sarah Anderson PharmD, BCPS of the CU Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences and Margaret Gedde, MD, PhD of Gedde Whole Health.

Source: David Kelly – University of Colorado Anschutz Medical Campus
Image Source: The image is in the public domain
Original Research: Full open access research for “Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population” by Danielle N. Rhyne, Sarah L. Anderson, Margaret Gedde and Laura M. Borgelt in Pharmacotherapy. Published online January 9 2016 doi:10.1002/phar.1673


Abstract

Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population

Study Objective
No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache.

Design
Retrospective chart review.

Setting
Two medical marijuana specialty clinics in Colorado.

Patients
One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit.

Measurements and Results
The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (p<0.0001) with the use of medical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms.

Conclusion
The frequency of migraine headache was decreased with medical marijuana use. Prospective studies should be conducted to explore a cause-and-effect relationship and the use of different strains, formulations, and doses of marijuana to better understand the effects of medical marijuana on migraine headache treatment and prophylaxis.

“Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population” by Danielle N. Rhyne, Sarah L. Anderson, Margaret Gedde and Laura M. Borgelt in Pharmacotherapy. Published online January 9 2016 doi:10.1002/phar.1673

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