Migraine Headache

Migraines are recurrent headache episodes often lasting up to 24 hours or more, involving moderate to severe pain. The pain is often one-sided throbbing, accompanied by nausea, vomiting, dizziness, and sensitivity to light, sound, and other sensory stimuli. The mechanism involves an initial vasoconstriction followed by a rebound vasodilation of head blood vessels, requiring different therapy at each stage. It occurs more often in women, with a peak incidence in middle age. 70% of migraine sufferers have a family history indicating a biochemical cause. It is often hormonally mediated, associated with oral contraceptive use and may or may not be alleviated by menopause. Triggers include alcohol, aged cheeses, red wine, chocolate, changes in altitude or weather, and hunger, sleeplessness or stress. Consideration of nicotine and/or caffeine use is important in that withdrawal from either can bring on a migraine. Emotional triggers including anxiety, stress, and anger may play a major role in precipitating a migraine as well.

 

Standard medical treatments:

NSAIDs (anti-inflammatory drugs)

Ergotamine derivatives

Triptan drugs

Intranasal medicines

Antidepressants

Anti-nausea drugs

Preventive adrenergic or calcium channel blockers

Pain medicine

 

Supportive and alternative treatments:

Nutritional – dietary restriction, eliminate allergens and triggers

5HTP – 5-hydroxytryptophan, an amino acid derivative, pre-serotonin

Ginger – anti-inflammatory

Herbal –

Feverfew – anti-inflammatory

Homeopathy – belladonna

Biofeedback

Massage therapy

Relaxation therapies

Acupuncture

Hormone balancing

Hydrotherapy – warm footbath, cold compress

Chiropractic

 

Migraine Headache and Cannabis

 

Often, when acute episodes of vomiting are present, oral medication cannot be used. In these instances patients usually receive treatment from an ER where IM or even IV injections are used. If vomiting is particularly severe dehydration is a consideration and IV fluids may be administered. Many of the medicines prescribed for the treatment and/or prevention of migraine can have serious adverse reactions and side effects. Non-drug preventative measures including recognizing and avoiding migraine “triggers” are important.

Cannabis preparations in the 19th century were widely prescribed for migraine. In England and America, cannabis was the primary drug used to treat “sick headache.” Cannabis contains a variety of cannabinoids that act synergistically to help relieve migraine symptoms. Recent research demonstrates that cannabis is also a mild vasodilator that can lower blood pressure. It is important to use cannabis at the earliest signs of the start of a migraine, so that the vasodilation effect can put a halt to the progression into a full blown headache. Tinctures are available that are absorbed under the tongue (sublingual) and work in minutes. Inhalation through a vaporizer or smoking can produce even more rapid relief. Cannabis is both anti-inflammatory and analgesic in addition to its known anti-emetic properties. Cannabis can provide relief from muscle cramps that can accompany migraine (particularly of the neck and shoulders).