Clinical trial looks at cannabis as a potentially effective treatment for acute migraines

Allison Knigge was in elementary school when she started to experience migraines. They continued to get progressively worse as time went on, especially after the birth of her son.

"I would describe my migraines as a piercing pain. It feels like my brain is being squeezed. It causes extreme sensitivity to light and sound and horrible nausea," said Knigge. "There have been times when I have been at a pain level of 6 or higher for approximately 25 days out of the month. They impact my quality of life."

Migraines produce symptoms that are often intense and debilitating. They cause severe throbbing or pulsating headaches, usually on one side of the head, often accompanied by nausea and sometimes vomiting and/or extreme sensitivity to light and sound. A migraine attack can last for hours or even days.

Knigge says she has tried several medications over the years, but none have been able to fully manage her migraines.

"My migraines are triggered by the weather, stress and lack of sleep. When the pain gets to peak levels, I am in bed all day with the lights out," said Knigge. "When I am experiencing a migraine, I am completely out of commission, and that is a challenge as a mom."

Although there are numerous FDA-approved treatments on the market, experts say many patients are turning to cannabis products containing THC and/or CBD, an ingredient of cannabis that is not psychoactive, to treat their migraines.

"Many patients who suffer from migraines have experienced them for many years but have never discussed them with their physicians. They are, rather, self-treating with various treatments, such as cannabis," said Nathaniel Schuster, MD, pain management specialist and headache neurologist at UC San Diego Health and investigator at the UC San Diego Center for Medicinal Cannabis Research. "Right now, when patients ask us if cannabis works for migraines, we do not have evidence-based data to answer that question."

Schuster and his team at UC San Diego Health are conducting the first known randomized, double-blind, placebo-controlled clinical trial looking at cannabis as a potentially effective treatment for acute migraines.

Approximately 20 participants are currently enrolled in the clinical trial. Knigge is one of them.

"When Dr. Schuster introduced the trial to me, I decided I wanted to participate. I was at a point where I was willing to try anything that could help manage my migraines," said Knigge.

The goal is to enroll 90 participants who will be randomized to treat four separate migraine attacks with four different treatments; one each with THC, CBD, a combination of the two and a placebo. The products are administered via a vaporizer.

Vaporized cannabis may be more effective for those patients who have nausea or gastrointestinal issues with their migraines."

Nathaniel Shuster, Assistant Professor, Department of Anesthesiology, UC San Diego School of Medicine

To qualify for the clinical trial, patients must experience migraines every month, must not be a regular cannabis user or use opioids, and must be age 21-65.

"I am proud and grateful to be part of a study that could lead to more tools in the toolbox for those of us who suffer from migraines," said Knigge. "It could mean one more option when all other options have not worked. This is truly significant for patients whose lives are disrupted on a regular basis from migraines."

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