Cannabinoids are as effective as other treatments for migraine attacks, an Italian study has revealed.
However, they are only useful for treating cluster headaches if patients have suffered migraines from childhood, a European conference was told.
The findings from a study by Dr Maria Nicolodi, of the Interuniversity Centre, Neurochemistry and Clinical Pharmacology of Idiopathic Headache, Inst. of Internal Medicine IV, Florence, Italy, was presented at the 3rd Congress of the European Academy of Neurology in Amsterdam this weekend.
Dr Nicolodi and her team gave a group of 48 chronic migraine volunteers a starting oral dose of 10mg of a combination of two compounds, one which contained 19% tetrahydrocannabinol (THC), and the other that had virtually no THC and 9% cannabidiol (CBD) content.
They found that doses of less than 100mg produced no effects and that only when an oral dose of 200mg was administered that pain reduced by 55%.
In the phase 2 study, 79 chronic migraine patients were given either 25mg of amitriptyline – a tricyclic antidepressant commonly used to treat migraine – or 200mg of the THC-CBD combination every day for three months.
Over the same period, 48 cluster headache patients also received either 200mg THC-CBD or a daily dose of 480mg of the calcium channel blocker verapamil. For acute pain, an additional 200mg TCH-CBD was administered for both types of headaches.
After the three-month treatment time, the volunteers were followed up for four weeks and the researchers found that while the TCH-CBD combination yielded slightly better results than amitriptyline (40.1%) with a 40.4% reduction in attacks, the severity and number of cluster headache attacks only fell slightly.
When they analysed the treatment of acute pain, the researchers found that cannabinoids reduced pain intensity among migraine patients by 43.5%. The same results were seen in cluster headache patients, but only in those that had experienced migraine in childhood.
“We were able to demonstrate that cannabinoids are an alternative to established treatments in migraine prevention,” said Dr Nicolodi. “That said, they are only suited for use in the acute treatment of cluster headaches in patients with a history of migraine from childhood on.”
3rd EAN Congress Amsterdam 2017, Abstract Nicolodi, et al. Therapeutic Use of Cannabinoids – Dose Finding, Effects and Pilot Data of Effects in Chronic Migraine and Cluster Headache.
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