Dr. Stephen Silberstein touches on CBD oil as a potential treatment for migraine and current barriers to its use. Find out what the most recent research says about the safety and effectiveness of CBD oil for migraines.
Migraine and CBD Oil: Doctor Q&A With Stephen Silberstein, MD, FACP, FAHS
Dr. Stephen Silberstein touches on CBD oil as a potential treatment for migraine and current barriers to its use
Dr. Stephen Silberstein is the director of the Headache Center at Jefferson University Hospital in Philadelphia. At the 60th Annual Scientific Meeting in San Francisco, Dr. Silberstein spoke with us about cannabidiol (CBD) and its relationship to the treatment of migraine and headache disorders.
What is CBD oil, and how is it different from marijuana?
Marijuana contains both tetrahydrocannabinol (THC), an active chemical that has psychoactive properties, and CBD. Unlike THC, CBD oil has no psychoactive properties and is currently on the market and available for purchase in stores and online.
There is a debate in the field of headache medicine right now. Health care professionals are currently asking if patients are better off using the marijuana plant and its extracts, which are natural, or if they are better off using the specific chemicals that come from marijuana, like THC and CBD? It is frequently debated, and there are people on both sides of the fence.
Is CBD oil effective for preventive or acute treatment of migraine?
There is very little evidence that any of the components of marijuana are effective for the treatment of migraine and headache disorders. That does not mean they do not work, however. What it means is that they have not been studied.
What are some of the obstacles patients with migraine and headache disorders face when it comes to using CBD oil?
Some states are legalizing marijuana and its derivatives; however, marijuana is still a federal crime. So, theoretically, if you bought marijuana in a state where it is legal and you travel to another state where it is illegal, you could be arrested by that state or even by the federal government.
In addition, studying marijuana and its derivatives is extremely difficult. There is only one source of plants researchers can use, and they are at a research facility in Mississippi. They are not the best, most pure plants for study.
Accessibility to CBD oil is widespread. You can order it from Amazon and Walmart.com. What are the legal implications of CBD oil?
It is a complicated topic. I can legally prescribe THC and there is no problem with that, but I could not legally prescribe CBD oil until recently, because it has just been approved by the Food & Drug Administration (FDA) for the treatment of epilepsy. Now, we will have CBD and THC both available as prescription drugs, despite the fact that it is still illegal to use the plant, according to the federal government.
What research exists on CBD oil and marijuana as treatment options for migraine?
There are no studies that have been done on either marijuana or CBD oil as treatment options for migraine, and no studies are in the pipeline.
If a physician has a patient who wants to explore CBD oil as a treatment option for migraine, how would you advise him or her?
It depends on your state. If you are in a state where it is illegal, you have no local or federal protection. But if you are in a state where it is legal, either recreationally or medicinally, you have options. For example, in Pennsylvania where I practice, marijuana is legalized for medicinal uses. But physicians in the state of Pennsylvania cannot prescribe it. If they did, their license would be removed, as it is a federal offense.
In some states, it is legal for recreational use, so there is no physician intermediary. Every state is different, and it is extremely important to know the laws in your state.
How does CBD oil interact with common migraine medications?
Theoretically, it should not interact at all. It works on an entirely different mechanism. It might even prevent nausea and vomiting. I cannot think of any reason why it could not be used in conjunction with other migraine medications.
What are the side effects of CBD oil?
Practically none. Unlike THC, CBD oil has minimal, if any, side effects.
Stephen Silberstein, MD, FAAN, FACP, FAHS, is a member of the American Headache Society, a professional society for doctors and other health care workers who specialize in studying and treating headache and migraine. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders, and to share and advance the work of its members. Learn more about the American Headache Society’s work and find out how you can become a member today.
Can CBD Oil Treat a Migraine?
Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer’s research.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Huma Sheikh, MD, is a board-certified neurologist, specializing in migraine and stroke, and affiliated with Mount Sinai of New York.
With the laws governing the legal use of medical marijuana beginning to loosen up, there’s quite a bit of focus on the use of CBD oil—a component of the marijuana plant—for treating everything from arthritis to chronic pain, including migraines. But what is CBD oil, and does it really work to relieve migraine headaches?
Verywell / Ellen Lindner
Cannabidiol (CBD) is just one of over 100 different substances found in the the Cannabis sativa plant. The portion of the cannabis plant that produces a high (the psychotropic effect) is called tetrahydrocannabinol, or THC. Depending on how it’s processed, CBD oil contains very little (or is completely void of) THC.
Due to the pervasiveness and debilitating effects of migraine headaches, there’s been a lot of clinical research aimed at trying to find an effective treatment to minimize the frequency of migraines and alleviate the pain.
Medical experts currently consider the pain from a migraine headache the result of intense stimulation to sensory nerves—a response to inflammatory agents which are released when a migraine occurs. This would explain why powerful analgesic and anti-inflammatory agents, such as CBD oil, may be effective in the treatment of migraines.
Properties of CBD Oil That Relieve Migraine
- Potent analgesic (pain relieving) properties
- Antiemetic (preventing nausea and vomiting) properties
- Powerful anti-inflammatory effects
CBD oil has gotten a lot of attention for its powerful pain-relieving properties, particularly since cannabis use is becoming legal in many states (33 as of October 2019, according to the National Conference of State Legislatures, but details vary). In June 2018, the FDA approved CBD for the first time for a new seizure medication called Epidiolex (cannabidiol) [CBD] oral solution.
According to a study published in Frontiers in Pharmacy, while there are many experts who advocate for the use of CBD oil for migraines, there is still not enough evidence to prove that treatment will CBD oil will be completely effective for alleviating migraine headaches.
The researchers add that given time, as the legalities around medical marijuana and CBD oil change, more research may be able to show that CBD oil works well enough and consistently enough to treat migraines.
“Cannabinoids—due to their anticonvulsive, analgesic, antiemetic, and anti-inflammatory effects —present a promising class of compounds for both acute [short-term, severe] and prophylactic [preventative] treatment of migraine pain,” explained lead study author Pinja Leimuranta, of the University of Eastern Finland. Although the researchers say that we are not completely there yet, they add that CBD oil can “absolutely help relieve some symptoms related to migraines.”
While few clinical research studies have examined the use of CBD to treat migraines, a 2016 study, published in Pharmacotherapy, found that the frequency of migraines was reduced from nearly 10 per month to only approximately four per month in a group of medical marijuana users. Research presented in 2017 at the Congress of the European Academy of Neurology showed that cannabinoids might help prevent migraines as well as easing the pain of migraine headache.
Additionally, a 2017 review of cannabis treatment for headaches outlined existing research, patient surveys, and case reports showing the efficacy of cannabis for migraine and other headache disorders. A 2018 review described experimental evidence for the use of cannabinoids in the treatment of migraine as well as other headaches and chronic pain.
Uses and Safety
Previous research studies have shown that CBD oil, unlike THC, does not cause a euphoric high or psychotropic effects, and is typically less controversial and safer for medicinal use. CBD oil has been shown, in a limited number of studies, to be effective in the treatment of many disorders, including diabetes, arthritis, multiple sclerosis, and migraines.
The type of cannabis that CBD is composed of is well tolerated and safe in humans. In one study, when cannabis with THC was given to study subjects, they experienced an increased heart rate, anxiety, and psychotic symptoms. However, participants who took CBD oil—lacking THC—did not experience side effects (including psychotic symptoms).
Should You Use It?
Anyone considering the use of CBD oil for migraines should consult with their healthcare provider before taking it. It’s important to note that not all sources of the product are reputable.
Prescription drugs with CBD do not have any THC at all. But many over-the-counter CBD oil products, such as those sold online, contain trace amounts of THC.
Another important action step to take before deciding to use CBD oil is to check to ensure that it is legal in your home state. Many states still consider even the prescribed use of CBD oil illegal, due to its link to marijuana. And the FDA has not approved any CBD products (prescription or over-the-counter), aside from Epidiolex.
This certainly does not indicate that people with migraines should stop searching for an effective treatment to alleviate pain and discomfort, nor should they give up hope. There are many proven effective solutions available for those who suffer from migraine headaches.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lochte BC, Beletsky A, Samuel NK, Grant I. The use of cannabis for headache disorders. Cannabis Cannabinoid Res. 2017;2(1):61-71. doi:10.1089/can.2016.0033
Leimuranta P, Khiroug L, Giniatullin R. Emerging role of (endo)cannabinoids in migraine. Front Pharmacol. 2018;9:420. doi:10.3389/fphar.2018.00420
Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708-1709. doi:10.1001/jama.2017.11909
Nicolodi M, Sandoval V, Terrine A. Therapeutic use of cannabinoids – dose finding, effects, and pilot data of effects in chronic migraine and cluster headache. Abstract presentation at 3rd congress of the European Academy of Neurology (EAN), Amsterdam, 2017.