A pilot study published by the National Library of Medicine took a closer look at the relationship between cannabis and migraines found that inhalation of flower with both CBD and THC may be key to providing migraine relief. The data has not yet been peer reviewed. Authors note the existing preclinical and retrospective studies suggesting that cannabinoids could be effective in treating migraines, though there are still no randomized clinical trials to assess efficacy. Additionally, they note the prevalence of acute treatments for migraines, like acetaminophen or ibuprofen, though rates of treatment optimization in this regard tend to be low with high rates of discontinuation.

  To examine how cannabis may help to curb migraine symptoms, researchers from the University of California, San Diego (ECSD) conducted a randomized, double-blind, placebo-controlled crossover trial with herbal cannabis, the first of its kind according to the study. The trial involved 92 patients with persistent migraines. Participants were randomly assigned one of four cannabis chemotypes: 6% THC, 11% CBD, 6% THC and 11% CBD or a placebo. Upon each migraine attack onset, participants were instructed to open a smartphone application, which would prompt participants with questions surrounding whether or not the attack met the criteria for cannabis administration (if more than seven days had elapsed since the last administration, if it was less than four hours from headache onset, gauging the severity of pain, other symptoms associated with the migraine and that no acute treatments had been used since the attack onset).

  So long as participants met the set criteria, the app would then instruct them to vaporize cannabis, inhaling for five seconds, holding their breath for 10 seconds and then waiting 45 seconds before repeating the process four times. The app then pushed surveys to participants at one, two, 24 and 48 hours following application to gauge efficacy. Ultimately, the study concluded that the vaporized cannabis containing THC and CBD was most effective in treating migraines. It also found that the THC/CBD blend was superior to the placebo when it came to relieving migraine-related photophobia, or light sensitivity, and phonophobia, sound sensitivity.

“Vaporized 6% THC+11% CBD cannabis flower was superior to placebo for pain relief, pain freedom, and MBS [most bothersome symptom] freedom at 2 hours as well as 24-hour sustained pain freedom and sustained MBS freedom and 48-hour sustained MBS freedom,” authors reported, emphasizing that this blend was the only one to provide sustained benefit versus the placebo.  The study found that blends dominant in THC and CBD showed no difference from the placebo surrounding 24- or 48-hour sustained pain and MBS freedom.

Regardless of the type of cannabis consumed, there were no serious adverse effects reported by participants. However, the THC-dominant blend provided the most euphoria, cognitive impairment and subjective highness, followed by the THC/CBD blend and then the CBD-dominant flower. The study did not assess repeated administration or regular, long-term treatments, though researchers note a small body of literature that has found improvements on patient-reported outcomes when using cannabis-based medicinal products on regular, longer-term or preventative basis.

  The study also only looked at single potencies of THC and CBD and a single THC:CBD ratio, and minor cannabinoids and terpenes were also left out of the study. In the study’s conclusion, researchers still cited the need for further research to include multicenter and long-term studies of benefits and risks regarding repeated use of cannabis to treat migraines. Read less