Migraines and headaches – does CBD help?

When talking about the therapeutic effects of CBD, it’s often the cannabinoid’s analgesic effect that is mentioned. As headaches are the most common source of pain in the general population, it would make sense then that CBD for migraines is an obvious therapeutic target.
Migraines and headaches are a bit of a medical mystery, but is usually credited to dysfunctional brain stem centres. So far, the only treatment for headaches and migraines have been painkillers such as paracetamol or ibuprofen, as well as Triptans that constrict the blood vessels and block pain pathways in the brain. But perhaps there is a better way to treat headaches and migraines.

Cannabis – a long history of treating headaches

CBD oil for headaches is not as recent a therapy as you’d suppose. The cannabis plant is mentioned as a treatment for headaches in ancient texts dating back thousands of years, though its use only became commonplace in the west during the 19th century when it was prescribed by many doctors as a tincture. However, all that changed with prohibition in the 1930s, and since then for many the cannabis plant’s capacity to quell a headache has merely become a welcome side effect of its recreational use. These days, aside from the multitude of anecdotal reports relating to medical cannabis and hemp oil for headaches, conclusive clinical evidence is lacking. But what scientists do know is that when it comes to CBD oil for headache disorders such as migraines, the endocannabinoid system is inherently linked.

Migraines and the Endocannabinoid System

One theory posited about a possible contributing cause of migraines is a dysregulation in the endocannabinoid system (ECS) – the body’s complex network of receptors and cannabis-like chemicals that act to modulate pain, the immune system, mood, sleep, appetite and memory. Scientists have observed several ECS mechanisms that may have an implication in migraine attacks. Anandamide (AEA) one of the prime endocannabinoids in the body, is both analgesic and has been found to potentiate the serotonin 5-HT1A receptors. Studies also suggest that endocannabinoids inhibit the trigeminovascular system.   But perhaps the clearest indication of endocannabinoid dysfunction contributing to migraines is a study carried out in 2007 at the University of Perugia and published in the Journal of Neuropsychopharmacology.Researchers measured endocannabinoid levels in the cerebrospinal fluid of patients with chronic migraines finding significantly lower amounts Anandamide, concluding that this “may reflect an impairment of the endocannabinoid system in these patients, which may contribute to chronic head pain.”

Are migraines a sign of Clinical Endocannabinoid Deficiency?

This link between lower levels of endocannabinoids in migraine patients has contributed to the formulation of what has been termed Clinical Endocannabinoid Deficiency, a theory developed by Neurologist and Cannabinoid Researcher Dr Ethan Russo. Based on the idea that many brain disorders are associated with a lack of certain neurotransmitters such as acetylcholine, Russo has suggested that “a comparable deficiency in endocannabinoid levels might manifest similarly in certain disorders that display predictable clinical features as sequelae of this deficiency.”
In an interview with project CBD he described how “If you don’t have enough endocannabinoids you have pain where there shouldn’t be pain. You would be sick, meaning nauseated. You would have a lowered seizure threshold. And just a whole litany of other problems.” Russo says that this deficiency can be addressed by introducing plant cannabinoids, which act much like those found in the body by stimulating the endocannabinoid receptors. While CB1 agonists such as Marinol and Nabilone have been tested for migraines, Russo suggests that the ECS needs a “gentle nudge” rather than the “forceful shove” given by these synthetic variants. He suggests small doses of whole plant cannabis, which contain “additional synergistic and buffering components, such as CBD and cannabis terpenoids.” So how can CBD for migraines be of any help?