Cannabinoids and Hallucinogens for Headache

From the Department of Neurology, Boston Medical Center & Boston University, Boston, MA, USA.
Headache The Journal of Head and Face Pain (Impact Factor: 2.71). 10/2012; 52 Suppl 2(3):94-7. DOI: 10.1111/j.1526-4610.2012.02245.x
Source: PubMed


Most hallucinogens and cannabinoids fall into Federal Controlled Substances schedule 1, meaning they cannot be prescribed by practitioners, allegedly have no accepted medical use, and have a high abuse potential. The legal and regulatory status has inhibited clinical research on these substances such that there are no blinded studies from which to assess true efficacy. Despite such classification, hallucinogens and cannabinoids are used by patients with headache on occasion. Cannabinoids in particular have a long history of use for headache and migraine before prohibition and are still used by patients as a migraine abortive. Hallucinogens are being increasing used by cluster headache patients outside of physician recommendation mainly to abort a cluster period and to maintain quiescence for which there is considerable anecdotal success.

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    Headache The Journal of Head and Face Pain 01/2012; DOI:10.1111/j.1526-4610.2011.02072.x · 2.71 Impact Factor
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    ABSTRACT: Cluster headache patients seem to use more licit and illicit substances than the general population. The epidemiologic data supporting this is growing. We included the licit drugs in this review because their use seems to be driven by the same addiction mechanisms leading to illicit drug abuse. Some drugs may be used in an attempt to treat cluster headache, especially cocaine and hallucinogens. Drug exposure may also play a role in CH pathophysiology, as suggested by interesting data on tobacco use and second-hand smoke exposure. A common factor may contribute both to CH and drug use predisposition. Genetic factors may be at play, and the dopaminergic and orexinergic pathways could be targeted for future studies.
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