How Effective Is CBD for Migraines?

Migraines are more than bad headaches; they're a debilitating neurological condition. As sufferers search for relief, an unexpected remedy has emerged — CBD. Once overshadowed by its psychoactive cousin THC, the non-intoxicating CBD is gaining attention for its potential to alleviate symptoms of neurological health conditions. For instance, cannabidiol (Epidiolex) has been approved as a treatment for a rare form of epilepsy.

Could CBD work for migraine pain, too? In this article, we’ll explore what the existing research says about CBD and migraines.

Understanding migraines

A migraine is a debilitating type of headache. Migraines are usually recurrent attacks of moderate to severe throbbing, pulsating pain on one side of the head. Attacks can last from 4 to 72 hours and are usually accompanied by other symptoms, such as nausea, vomiting, and sensitivity to light and sound.

Beyond being a severe headache, migraines are a complex neurological disorder that affects over a billion people globally and is the second leading cause of disability worldwide.

What are the symptoms of a migraine?

Migraine attacks typically unfold in four phases, each with its own, distinct symptoms.

• Prodrome phase. Occurs around 24–48 hours before the headache, with symptoms such as yawning, mood changes, lethargy, neck pain, and sensitivity to light and sound.
• Aura phase. During the aura phase, which affects 25% of people with migraines, individuals may experience visual disturbances like shimmering zigzag lines and sensory symptoms such as tingling or numbness.
• Headache phase. In the headache phase, a throbbing pain on one side of the head that can last for days is accompanied by nausea, vomiting, and sensitivity to light, sound, or smells.
• Postdrome phase. After the headache subsides, the postdrome phase is marked by lingering symptoms like fatigue, dizziness, and difficulty concentrating.

What are the triggers of migraine headaches?

Symptom triggers are factors that contribute to the development of a migraine episode. Nearly three-quarters of migraine sufferers report triggers, and these can vary from person to person.

Migraine triggers fall into five main categories: emotional stress, menstrual-induced, sleep disturbance, food and alcohol, and weather changes.

For women, the most common migraine triggers include the menstrual period, stress, and bright lights, while men most commonly report sleep deprivation, stress, and bright lights.

Other triggers include skipping meals, sleep disturbances, high altitudes, weather changes, alcoholic beverages, specific foods, and strong odors like perfumes and paints.

Conventional treatments for migraine

Once a migraine has started, the aim of treatment is to stop the headache as quickly as possible. For mild to moderate attacks, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin are commonly used.

For more severe migraines, triptans such as sumatriptan or zolmitriptan can be effective; however, these need to be used with caution in patients with heart conditions, a history of stroke, and certain types of migraine.

Also, a study suggested that a combination of NSAIDs with triptans can be more effective than using either alone.

Preventative medications for migraine can be used by individuals with frequent or long-lasting headaches, those experiencing significant disability, and those who cannot use or do not respond well to the above therapies. These include beta-blockers (like metoprolol and propranolol), low-dose antidepressants (such as amitriptyline), anticonvulsants (valproate acid and topiramate), and calcium channel blockers (verapamil), among others.

How CBD works for migraines: does it help?

While CBD has gained popularity for its potential health benefits, its effectiveness in treating migraines remains under investigation. Let's explore the current research to understand how CBD might help alleviate migraine symptoms.

There’s no human research proving that CBD is effective as a migraine treatment, but animal studies and our understanding of how migraines happen suggest that it could be a useful tool in the armory.

In a 2023 study, mice were injected with CGRP, a protein that causes migraines. When CBD was given before CGRP, it had a protective effect against pain. When given after, a single dose of CBD reversed migraine pain and other symptoms of migraine. Overall, the study showed that CBD could potentially be effective for migraine-associated symptoms in mice. Other laboratory-based studies suggest that CBD may have anti-inflammatory and painkilling effects.

While there are no human studies directly measuring the effect of CBD as a treatment for migraines, this research suggests that CBD could have a role to play.

Our understanding of how migraines and pain occur suggests that CBD may help reduce migraines. However, further research in humans is needed to substantiate these potential health benefits of CBD.

Mechanisms by which CBD may reduce pain

Pain is a complicated phenomenon governed by multiple pathways and mechanisms throughout the body. CBD primarily acts on the endocannabinoid system (ECS), a network of nerves, receptors, and chemical transmitters regulating a range of functions, from mood, learning, and memory to immune system function and pain. CBD is also known to increase levels of endogenous cannabinoids, naturally occurring neurotransmitters, known to potentially play a role in migraine management.

Outside of the ECS, CBD is hypothesized to affect migraine pain through several pathways. One of the proposed pathways includes the anti-inflammatory effects of CBD. Also, CBD is proposed to affect migraine pain through its effects on serotonin levels.

The current theory on how migraine pain develops is linked to the trigeminovascular system (TGVS), which during a migraine episode, is activated and can manifest in headache. This pain then creates a feedback loop that further stimulates the TGVS, causing more pain and inflammation.

Research suggests that CBD may help reduce this feedback loop by lowering levels of CGRP, a key compound involved in the development of migraines.

These combined effects make CBD a promising option for reducing the frequency and severity of migraine. However, more research is needed.

How to use CBD for migraines

Currently, there is no research indicating which form of CBD is the best for migraines. CBD comes in various forms and choosing the right depends on personal preference and health status.

Here are the most common forms of CBD:

• CBD oils and tinctures. These are popular because they can be taken under the tongue for quick absorption or added to food and drinks. They offer flexibility in dosage and fast relief.
• Edibles. CBD-infused gummies and other edibles are a tasty and convenient option. However, they take longer to be absorbed because they must pass through the gut first.
• Capsules and pills. These offer a consistent dosage and are easy to incorporate into your daily routine, but like edibles, may take longer to work.
• Topicals. CBD creams, balms, and lotions can be applied directly to the skin. Typically used for localized pain relief, they may be helpful for headaches when applied to the temples or neck.

It might take some time and consideration to find the CBD product that works best for you. Always consult with a healthcare professional to find out the right method and whether using CBD is safe for you.

CBD oil dosage for migraines

There’s no research on the optimal dosing of CBD for migraines. However, the general advice on any medical cannabis dosing is to start at the lowest dose recommended by the CBD product manufacturer and to consult a healthcare professional before introducing CBD into your existing migraine plan.

When starting with CBD, consider the following:

• Begin with a low dose. Start with the smallest possible dose and observe how your body responds.
• Monitor your response. Keep track of any changes in your symptoms.
• Consult a healthcare professional. They will be able to help you work out if your dosage needs adjustment.

Possible side effects of using CBD for migraines

CBD has possible side effects, drug interactions, and legal and regulatory issues that should be considered before use.

Research has shown that CBD is generally safe. However, side effects may include drowsiness, changes in mood such as irritability and agitation, decreased appetite, and gastrointestinal discomfort.

Additionally, CBD use has been linked to the effects on liver enzymes and potential interactions with other medications.

The likelihood of side effects depends on various factors, such as CBD strength, dose, the use of other substances (legal or illegal drugs and alcohol), and interactions with prescribed medications.

Interactions between CBD and other medicines

CBD can interact with various medications, potentially altering their effectiveness or increasing the risk of adverse effects. Some common medications that can interact with CBD include:

• Anti-epileptic drugs
• Antidepressants
• Anti-cholesterol medications
  
• Psychiatric medications
• Opioids: Morphine, Codeine, Fentanyl, Heroin

Legality and regulations of CBD

The legal status of CBD varies widely. In the United States, the 2018 Farm Bill legalized hemp-derived CBD products containing less than 0.3% THC at the federal level. However, individual states have their own regulations, so It's important to check local laws before purchasing or using CBD.

The FDA does not regulate CBD products in the same way it regulates pharmaceuticals. This means that the quality and concentration of CBD can vary significantly between products. When choosing a CBD product, look for those that have been third-party tested to ensure they contain the stated amount of CBD and are free from contaminants.

Should you try CBD for migraine relief?

Research on CBD’s effectiveness for migraines is very limited, but some rodent studies propose that it may help reduce the frequency and severity of headaches. Deciding whether to try CBD for migraine relief is a choice that should be made with your healthcare provider.

If you decide to try CBD, start with a low dose and monitor your body’s response. Choose high-quality, third-party tested products to ensure safety and efficacy and always check the legal status of CBD in your area.

While CBD may offer relief for some, more research in humans is essential. Consult with your healthcare professional to make an informed decision.