Rhyne Danielle N, Anderson Sarah L, Gedde Margaret, Borgelt Laura M
Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
Gedde Whole Health, Littleton, Colorado.
Pharmacotherapy. 2016 May;36(5):505-10. doi: 10.1002/phar.1673. Epub 2016 Jan 9.
No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache.
Retrospective chart review.
Two medical marijuana specialty clinics in Colorado.
One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit.
The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (p<0.0001) with the use of medical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms.
The frequency of migraine headache was decreased with medical marijuana use. Prospective studies should be conducted to explore a cause-and-effect relationship and the use of different strains, formulations, and doses of marijuana to better understand the effects of medical marijuana on migraine headache treatment and prophylaxis.
目前尚无临床试验证明大麻对偏头痛患者的影响；然而，大麻素对中枢神经系统中血清素的潜在影响表明，大麻可能是一种治疗选择。因此，本研究的目的是描述医用大麻对偏头痛每月发作频率的影响。
回顾性病历审查。
科罗拉多州的两家医用大麻专科诊所。
2010年1月至2014年9月期间，121名被医生建议使用医用大麻进行偏头痛治疗或预防且至少有一次随访的成年偏头痛患者。
主要结果是使用医用大麻期间每月偏头痛发作的次数。次要结果包括使用的医用大麻的类型和剂量、先前及辅助性的偏头痛治疗方法以及患者报告的效果。使用医用大麻后，偏头痛发作频率从每月10.4次降至4.6次（p<0.0001）。大多数患者使用不止一种形式的大麻，且每日使用以预防偏头痛。48名患者（39.7%）报告有积极效果，最常见的效果是预防偏头痛且偏头痛发作频率降低（24名患者[19.8%]）以及偏头痛发作中止（14名患者[11.6%]）。吸入形式的大麻常用于急性偏头痛治疗，据报告可中止偏头痛发作。14名患者（11.6%）报告有负面影响；最常见的影响是嗜睡（2名患者[1.7%]）以及与剂量的时间和强度相关的难以控制大麻的效果（2名患者[1.7%]），这些情况仅在使用食用大麻的患者中出现。与其他形式相比，食用大麻也被报告有更多负面影响。
使用医用大麻可降低偏头痛发作频率。应进行前瞻性研究以探索因果关系以及不同品种、剂型和剂量的大麻的使用情况，以便更好地了解医用大麻对偏头痛治疗和预防的影响。
