Vaporized THC, CBD combination efficacious in migraine treatment

AUSTIN, Texas — A combination of THC and CBD administered via vaporization was beneficial in migraine treatment, relieving pain and patients’ most bothersome symptoms, according to a study presented here.

“We have numerous lines of emerging evidence, we have preclinical evidence, we have clinical evidence that’s really just surveys and retrospective studies prior to this study funded by the Migraine Research Foundation to study the effects of cannabis in acute migraine,” Nathanial M. Schuster, MD, of UC San Diego Center for Pain Medicine, said.

Schuster and colleagues conducted a randomized, double-blind, placebo-controlled crossover trial in which 73 patients who experienced chronic migraines treated up to four distinct migraine attacks with vaporized THC 6%, a mix of THC 6% and CBD 11%, CBD 11% or placebo cannabis. The primary outcome was pain relief at 2 hours, while secondary outcomes included freedom from pain and most bothersome symptoms at 2 hours.

Participants were instructed to take four puffs from a vaporizer during the moderate or severe stage of migraine and to complete a questionnaire 2 hours after treatment. Repeat cannabis use during those 2 hours was not allowed and a washout of at least 1 week between treatments was required.

Following use of the THC/CBD combination, 69% of patients had pain relief, 36.2 % had pain freedom and 62.1% were free of their most bothersome symptoms.

These results compared with 70.5%, 29.5% and 49.2% following THC alone; 54.4%, 24.6% and 43.9% following CBD alone; and 48.3%, 15.5% and 36.2% following placebo.

“For pain relief at 2 hours, both THC alone and the THC/CBD mix were significantly greater than placebo, but for the 2-hour pain freedom it was only significant for the THC/CBD mix,” Schuster said.

No serious adverse events were reported with any of the products used, although mild adverse events were reported more with THC alone than the other groups.

“In this single center randomized controlled trial, four puffs of vaporized THC/CBD mix were efficacious for acute migraine treatment for pain relief, pain freedom and most bothersome symptom at 2 hours, and it was better tolerated than THC alone,” Schuster said. “Of course, we need future studies to test whether these results are replicable; multicenter studies are warranted and prospective, longitudinal studies are needed to evaluate for the risks with repeated use.”