What are cluster headaches?
Cluster headaches refer to a neurological condition that is characterised by intense and excruciating headaches that often occur in a cyclical pattern, or clusters. It occurs mostly in men, with a ratio of 9:1 with 9 being males. An attack may last for a couple of months with daily cycles of headaches, and the patient may experience as few as one to as many as eight attacks per day.
The headaches typically affect one side of the head, typically starting from the eye and radiating to other parts of the head. The pain is often accompanied by stuffy nose, teary eyes, forehead sweating, and psychological symptoms such as fear and anxiety. There is no cure for cluster headaches, and treatment usually revolves around symptom management.
Normal headaches are much more common. Medical cannabis is now a common treatment for headaches here in the UK.
Can medicinal cannabis cure cluster headaches?
The short answer is no, but the evidence so far suggest that medical cannabis may help to manage symptoms associated with cluster headaches, most notably, the excruciating pain. Furthermore, scientists are exploring the intricate relationship between the endocannabinoid system (ECS) and the basis of cluster headaches, which is a malfunctioning hypothalamus (the main connection between the endocrine and nervous systems).
This article highlights studies investigating medicinal cannabis administration in the treatment of cluster headaches and discusses how patients may apply medicinal cannabis to manage the condition.
Traditional application of medicinal cannabis to treat cluster headaches
Several reports indicate that the administration of medical cannabis to manage headaches dates back to thousands of years ago. One such record shows that second millennium BCE Assyrian manuscripts suggest that cannabis was taken to “bind the temples.” This implies the application of cannabis in treating migraines. In traditional Sri Lankan Ayurvedic medicine, cannabis was recommended for “disease of the head.” Notable physicians, including Queen Victoria’s personal physician, John Rusell Reynolds, also espoused the benefits of cannabis in managing severe pain.
Research on cluster headaches and medicinal cannabis
For the majority of the last century, research relating to the potential medicinal applications of cannabis was heavily restricted, thanks to the prohibition and demonisation of the plant. But, as many countries globally have moved to legalise cannabis and create more accommodative laws, researchers have found some wiggle room to not only conduct cannabis-focused research, but to even access funding for it. So far, the NHS has not funded any cannabis research here in the UK, but there is a big push for it from patients and their families.
One notable study on medicinal cannabis and cluster headaches was published in 2014. 18 adult participants using cannabis to manage cluster headaches, after traditional treatments had failed to provide adequate relief, were followed for a period of 3 years. A majority of the participants smoked an average of 1 gram of cannabis daily. Over 80% of the participants reported a 50% reduction in pain severity, while 11% reported a reduction in pain severity that was close to 100%. In addition, over 60% of the participants reported reduced dependency on prescription meds and better sleep at night.
A case study that was published in 2009 showed significant relief from cluster headaches after the patient was started on medical cannabis treatment and was later put on dronabinol (a synthetic form of THC). However, a more recent study involving 139 participants showed conflicting results. In this study, only 26% of the participants found relief from cannabis, while over 50% reported uncertain effects. 22% of the participants reported negative effects from cannabis administration.
Existing evidence points towards the potential for possible benefits in the prescription of medicinal cannabis for cluster headaches. However, many questions remain unanswered, highlighting the need for further clinical research.
Can CBD help with cluster headaches?
Cannabidiol, aka CBD, (a cannabinoid) in and of itself may not offer adequate relief for cluster headaches. However, it may offer supportive relief when offered with other medications for cluster headaches.
No research so far has looked at the administration of pure CBD in the management of cluster headaches.
However, some researchers have hypothesised that CBD could offer potential benefits. Some studies have found that CBD, in combination with THC, offers analgesic benefits. For example, one study that was published in 2021 found that a balanced of THC:CBD potentially offers adequate relief from migraine pain. CBD could also offer relief from the psychological symptoms that are associated with cluster headaches, such as fear and anxiety.
How medicinal cannabis works on cluster headaches
Scientists are yet to unravel the exact mechanisms through which cannabis offers relief for cluster headaches. It has been suggested that the hypothalamus has a role to play in this.
Science has established that cluster headaches, as a form of primary neurovascular pain, possibly originates from the hypothalamus. Neuroimaging studies have found that the hypothalamus is the genesis of cluster headaches, though the mechanisms are complex.
The hypothalamus has a vast network of endocannabinoid receptors. Medical cannabis compounds such as THC and CBD attach to these receptors to trigger a wide range of responses, both medical and recreational. It has been hypothesised that medical cannabis may be able to alter the course of cluster headaches by interacting with the endocannabinoid receptors in the hypothalamus.
Side effects of cannabis
Prolonged cannabis use may cause some side effects, which patients should be aware of. Cannabis strains that are high in THC are more likely to trigger such effects, while high CBD strains are likely to be well tolerated by most patients. Some of the side effects to anticipate include the following:
- Dry mouth and eyes
- Anxiety
- Euphoria
- Hunger
- Dizziness
- Paranoia
It is important to be aware that people respond differently to medical cannabis. It is possible that one might experience unique side effects that are different from what has been mentioned above. The science suggests that most people will also not experience any negative effects. It is important to be in touch with your healthcare provider regarding your medicinal cannabis dosage.
Are cluster headaches and migraines the same thing?
No, they are not, but both migraines and cluster headaches can cause intense, excruciating pain. Both issues also seem to respond well to medical cannnabis treatment options.
Conclusion
Preliminary evidence proposes that medical cannabis can be helpful in managing pain, reducing anxiety, and managing depression that are sometimes associated with cluster headaches. This may offer the much-needed relief for the hundreds of thousands of patients in the UK who suffer from cluster headaches each year. However, more evidence is needed to confirm the preliminary findings.
Do you suffer from cluster headaches? Are conventional treatment options failing to control the symptoms of the issues? Are you looking for alternative therapeutic options?
We are here to help. Accessing medical cannabis can be challenging due to the stigma surrounding it. However, Releaf makes it simple with our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, all based on your cannabis prescription.
