Studies suggest a promising benefit for cannabinoids in the etiology and treatment of migraine; however, there is limited research on the patterns of use and perceived benefits of this type of treatment in clinical headache patient populations.1 In a newly published survey on patients with migraine, a majority of respondents reported using cannabis products for managing their migraine. Respondents also reported on the perceived improvements in migraine characteristics, clinical features, and associated risk factors with using cannabis products. Overall, the data warrant further study in order to confirm the perceived benefits of cannabis products for migraine prevention and treatment.2
Conducted by senior author Allison Verhaak, PhD, and colleagues, patients from a tertiary headache center completed a 1-time online survey on cannabis use patterns and perceived benefits of cannabis-based products to treat migraine symptoms, clinical features, and risk factors. Investigators performed a descriptive analysis on the collected data from the survey. Using a cohort of 1373 patients, 55.7% reported cannabis-based product use in the past 3 years and 32.5% indicated current use. The most frequently reported reasons for cannabis-based product use were to treat headache (65.8%) and sleep concerns (50.8%).
Verhaak, who serves as a clinical psychologist from Ayer Neuroscience Institute at Hartford Healthcare Headache Center, had a conversation with NeurologyLive® to further discuss the reported benefits of cannabis-based products for headache management based on responses from the survey. She also talked about how stigma and perception may influence the use of cannabis among patients who experience migraine. Additionally, Verhaak spoke about the key challenges faced by patients in selecting and dosing cannabis products for migraine relief.
Top Clinical Takeaways
- Cannabis-based products show promise in reducing headache frequency, intensity, and associated symptoms like nausea, particularly among patients with fewer migraine days per month.
- Lack of knowledge about cannabis product selection and dosing poses a significant barrier to its widespread use for migraine management.
- Further research is needed to explore optimal compositions and dosages of cannabis products for effective migraine treatment and to understand the role of stigma in patients' treatment experiences.
NeurologyLive: What led you to explore the potential role of cannabinoids in migraine management?
Allison Verhaak, PhD: From clinical experience, we know that many of our patients at the headache center are using various types of cannabis-based products to treat headache and other medical or psychological conditions. However, research into cannabis use patterns in headache center patient populations is quite limited—most previous studies have focused on more general pain patient populations or individuals with headache in the general public.
Were there any unexpected findings or patterns in cannabis usage reported by the participants?
We found that over half of those who took the online survey reported using a cannabis-based product in the past 3 years, and approximately one-third were currently using cannabis products. It was also interesting that those with less migraine days per month (less than 15) reported greater benefit of cannabis use for headache frequency and sleep patterns, compared with those patients with higher headache frequency (15 or more days per month).
We also learned a lot about why some patients chose not to use cannabis-based products over the last 3 years, with around half of survey responders citing that they didn’t know what cannabis products to use or what dosage to take. This aligned with our clinical experiences of patients frequently asking our headache specialists for their thoughts on cannabis use for migraine management, and because of very few controlled research trials in this area, we still just don’t know enough to speak to this matter clinically.
Can you elaborate on the reported improvements in migraine characteristics and associated risk factors among participants using cannabis-based products?
Results suggest that the majority of survey respondents found some level of benefit from cannabis-based products in reducing headache frequency, duration, and intensity, in addition to migraine-associated features (such as nausea). For migraine risk factors and comorbidities, respondents reported the greatest improvements in sleeping patterns from cannabis use, followed by symptoms of anxiety and depression. Most of our participants reported using cannabis-based products for more than one reason, such as for both headache and sleep.
Did you observe any differences in perceived benefits or patterns of use between different types of cannabis products (e.g., inhaled vs. edibles)?
We didn’t look at this specifically, as survey participants could endorse more than one type of cannabis product used, and many participants endorsed using several different types.However, this is a great question, and certainly an area that needs further exploration in the future.
How do you plan to follow up on these findings, particularly in terms of experimental trials to confirm the perceived benefits of cannabis products for migraine prevention and treatment?
Our research group would certainly like to continue to explore how our patients use cannabis-based products, including clinical trials that may shed light on compositions or dosages that may be most beneficial for migraine management. We are also interested in how stigma may play a role in our patients’ lives. We know that there is stigma related to both having migraine and cannabis use, and it would be helpful to better understand how these factors impact individuals’ physical and mental health and treatment outcomes.
Transcript edited for clarity.
REFERENCES
1. Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy. 2016;36(5):505-510. doi:10.1002/phar.1673
2. Starkey B, Pearlson GD, Bond D, et al. Characterizing Cannabis Use and Perceived Benefit in a Tertiary Headache Center Patient Sample. Neurol Clin Pract. 2024;14(2):e200285. doi:10.1212/CPJ.0000000000200285
