Use of phytocannabinoids to treat migraine: the importance of correct dose
Notes based on clinical research conducted by Bárbara Arranz on the use of medical marijuana to treat patients with migraine.
You probably already know that headache is the general term for migraine . Within this spectrum, migraine headache is the official name for headache.
This type of headache has a neuromuscular origin, being responsible for major number of visits at SUS (Unified Public Health System) related to headache complaints. Generally, the most popular pain relievers do not relieve pain, which is usually intense, pulsating, and constant.
Migraine can cause continuous headache, which can occur with quite variable frequency and in moderate or severe intensity. Another feature is severe pain on one side of the head (called unilateral pain).
Migraine can temporarily hinder the performance in usual activities such as working or studying. Some people may also suffer nausea, vomiting and photophobia (sensitivity to light).
Studies that seek to show that phytocannabinoids (substances present in the cannabis plant) can bring benefits for the treatment of patients with migraine headaches have been around for decades.
Recently, I, Bárbara Arranz, have conducted a research – whose initial results you’ll see below – that shows cannabis oil really acts directly in the focus of headache. There is a clear correlation between modulation of the endocannabinoid system and pain signaling pathways in the central nervous system. You will understand it better soon...
Phytocannabinoids and migraine: use of medical marijuana to treat migraine attacks
Although the volume of scientific studies on the use of medicinal cannabis has been increasing in Brazil and worldwide in recent decades, we still have a long path to go through. The prejudice surrounding the plant and the lack of public initiatives to encourage research and development of drugs based on Cannabis make us fall far short of what we want.
Cannabis is a fascinating plant with more than 400 chemical components, including phytocannabinoids , terpenes and flavonoids. It is already known that our brain has a pair of receptors, CB1 and CB2, that react positively to cannabinoids . This pair, discovered between the late 80s and early 90s, was called the Endocannabinoid System. Cannabis acts not only on these receptors, but also on TRPV1 receptors and dopaminergic pathways.
What has been most studied since then is what can be done from it, what is the needed dosage and how the action of cannabinoids in the receptors can treat a series of diseases.
As a researcher who has been studying the power of medicinal cannabis for years, I decided to deeply understand how ‘full spectrum cannabis oil’ (one that retains all the cannabinoids and other components of the cannabis plant) can help migraine patients treat their issue.
In the survey, 420 patients with migraine were treated using full spectrum cannabis oil (with cannabinoids such as CBD and THC). The concentration used was 100mg/ml – each drop contained approximately 4.1mg of CBD. The dose could be given once in the morning or in the evening.
From the total number of patients, 59.5% (250) are women and 40.5% (170) are men.
Outcomes and importance of correct dose
The results of the oil administration were encouraging. Patients reported substantial improvement in migraine – both chronic and acute. None of the men reported adverse reactions to the treatment. Among women, there were some reports of mild reactions, such as tingling, sleepiness or nocturnal awareness. It's early to state the reasons, but I suspect it has to do with usual hormonal processes.
It is important to report that, with the adequacy of the dosage, side effects disappeared in most patients.
The highest dose administered to male participants was 49.2 mg, whereas the maximum dose administered to female patients was 36.9 mg. The greater tolerance of men to cannabinoids without having side effects is something that draws attention and needs further studies and scientific research.
From other studies, we find a joint action of CBD and THC in the process of migraine analgesia
It is important to bring this question of the right dose to light, as the dosage of cannabinoids in the treatment of migraine and other diseases is the key to determine the success or failure of the treatment.
But how to determine this dosage? At first, we need to conduct many studies! And farther. We cannot simply prescribe cannabis oil and wait for the patient to adjust the dosage on their own. Health professionals involved in medical marijuana research and prescription have a duty to provide care to patients and monitor their situation closely.
As a protocol, I advocate that every 5 days we should receive a patient report and based on such report, adjust the dosage, if necessary.
It is essential that the doctor who is going to prescribe a treatment based on medical cannabis makes an investigation of the patient's life in order to understand the context in which that patient is inserted and their background – clinical and social.
We shall accompany the patient's life and family history, the patient's routine, eating habits, emotional at that time, previous exams, reports, etc. Issues such as age, pre-existing illnesses and gender also need to be considered.
Each organism is a unique complex universe that reacts to cannabinoids in a different way. Understanding this principle, respecting such differences and treating each case as unique is what will make medicine and science advance towards safer cannabinoid dosage protocols for both the treatment of headache and other diseases.