Results from a new study have shown that a vaporised, balanced cannabis strain is a viable treatment for reducing symptoms during migraine attacks for up to 48 hours.
The study, published in Headache: The Journal of Head and Face Pain, involved 92 people with a median age of 41, 82% of whom were female. To be included in the study, participants had to have been experiencing between two and 23 headache days per month and between two and 23 migraine days per month.
Participants treated four separate migraine attacks with four different strains of cannabis flower: a THC-dominant strain, a CBD-dominant strain, a balanced strain and a placebo cannabis flower.
Participants were excluded if they had severe depression, a history of psychosis or substance use disorder, or active pulmonary disease. The study initially required participants to have used THC within the prior two years, but this criterion was removed in March 2021 due to slow recruitment and no serious adverse events.
The THC-dominant strain contained 5.62% THC and 0.03% CBD, the CBD-dominant strain contained 11.27% CBD and 0.35% THC, the balanced strain consisted of 6.16% THC and 10.77% CBD, and the placebo strain contained 0.025% THC and 0.14% CBD.
All of the strains were “devoid” of terpenes and contained less than 1% minor cannabinoids. Results from previous pain studies guided researchers when choosing which strains to include in the study. The flowers were vaped at 180°C using the Mighty Medic handheld vaporiser. A one-week “wash-out” period was left between each migraine attack treatment with one of the four strains.
Participant outcomes were recorded at one, two, 24 and 48 hours after treatment, and focused on pain reduction. Other outcomes recorded included pain freedom, sustained pain freedom, and each participant’s most bothersome symptom (MBS).
The balanced strain was demonstrated to be more effective for pain relief, pain freedom, sustained pain freedom and MBS when compared to the placebo strain. The THC-dominant strain, whilst superior to the placebo for pain relief, was not as effective at dealing with the other symptoms as the placebo.
“In this study, the first randomised, double-blind, placebo-controlled trial testing the efficacy of cannabinoids for acute migraine, 6% THC + 11% CBD was superior to placebo for pain relief, pain freedom, and MBS at two hours, as well as freedom from photophobia and phonophobia at two hours and 24-hour sustained pain freedom and sustained MBS freedom and 48-hour sustained MBS freedom,” wrote lead author Dr Nathaniel M. Schuster from the University of California San Diego Health System.
The balanced strain showed a 67% pain relief rate at two hours compared to 47% with placebo, whilst 35% of participants achieved complete pain freedom compared to 16% with placebo.
The study, conducted by researchers from universities in New York and California, was a randomised, double-blind, placebo-controlled crossover trial (RCT). Meaning that neither the participants nor the researchers knew which order they would receive the different treatments or which medicine was the placebo, the effectiveness of the cannabis treatments was compared to the placebo, and the treatments were given to the participants on different occasions.
This study design is important because there has been a lack of RCT studies in cannabis research. This is partly due to cannabis being difficult to blind as most people are aware of its distinct smell, taste and effects.
This study demonstrated that vaping a balanced cannabis strain can be more effective than a placebo for the treatment of migraine. While these results hold promise for those living with the condition, researchers stress the need for further research to be conducted.
“In this first randomized, double-blind, placebo-controlled trial testing the efficacy of cannabinoids for the acute treatment of migraine, vaporized 6% THC + 11% CBD cannabis flower was superior to placebo for pain relief, pain freedom, and MBS freedom at 2 h as well as 24-h sustained pain freedom and sustained MBS freedom and 48-h sustained MBS freedom. Future research should include multicenter RCTs and long-term studies of benefits and risks with repeated use,” the study concluded.
