A new leaf for migraine treatment? UCSD Health trial looks at effectiveness of cannabis

Allison Knigge was in elementary school when she started to experience migraines. They got 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,” Knigge said. “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 often are 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, who lives in Tierrasanta, said she has tried several medications over the years, but none has 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,” she said. “When I am experiencing a migraine, I am completely out of commission, and that is a challenge as a mom.”

Though several FDA-approved treatments are on the market, experts say many patients are turning to cannabis products containing tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, and/or cannabidiol (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 Dr. Nathaniel Schuster, a pain management specialist and headache neurologist at UC San Diego Health and an investigator at the UCSD 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 are conducting the first known randomized, double-blind, placebo-controlled clinical trial looking at cannabis as a potentially effective treatment for acute migraines.

About 20 participants are currently enrolled in the 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,” Knigge said.

The goal is to enroll 90 participants to treat four separate types of 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,” said Schuster, an assistant professor in the anesthesiology department at the UCSD 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,” Knigge said. “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.”

Schuster said future studies will include comparing different doses of cannabinoids.

To learn more about the clinical trial and how to enroll, visit clinicaltrials.ucsd.edu or contact Phirum Nguyen at psnguyen@ucsd.edu or (858) 822-3108.

— La Jolla Light staff contributed to this report. ◆