New Israeli study shows that cannabis could help alleviate migraines

New Israeli research has found that cannabis-based treatments have helped 61% of migraine sufferers, but the equally interesting question is what exactly cannabis does to them. After screening and testing, it was found that the amounts of THC and CBD, by which the Ministry of Health categorizes cannabis treatment, do not change the effect on the improvement of migraine.

According to the study, a hidden component, a cannabinoid that was not known to science until recently and that has not even received an “official” name, is one that may be the factor that relieves migraines. It is precisely the cannabis strains that contained higher amounts of this component, meanwhile called “ms_373_15c”, that were able to relieve migraine sufferers.

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Research points at cannabis as a promising treatment of migraine

Evidence of patients experiencing migraine relief from the use of medical cannabis is nothing new, and there is also physiological evidence for the involvement of the endocannabinoid system in migraines. 

For example, spinal fluid (CSF) of chronic migraine sufferers has a significantly lower concentration of endocannabinoid anandamide compared to healthy subjects.

However, research on cannabis and migraines is in its infancy and there is still insufficient clinical data on its efficacy in treating this delinquency. One of the problems is that the cannabis plant contains hundreds of active ingredients and it is impossible to know which one is having benefits on migraines.

Most research in medical cannabis to date has focused on the two components with the highest concentration in the plant, the cannabinoids THC and CBD, ignoring the other components. However, when it comes to migraines, the positive effect of cannabis does not seem to depend on its THC and CBD concentrations at all, but perhaps other components like the same ms_373_15c

61% of patients treated with cannabis reported migraine relief in a short period of time

In the study, conducted by Dr. Yehoshua (Shuki) Aviram under the guidance of Prof. Dedi Meiri of the Technion, and in collaboration with Prof. Elon Eisenberg of the Institute of Pain Medicine at Rambam Hospital, the researchers collected data from patients treated with medical cannabis, diagnosed with migraines.

Patients answered questionnaires in which they rated the monthly frequency of their migraine attacks when treated with cannabis, and the monthly frequency of their migraine attacks in the month before they started the cannabis-based treatment.

Based on their responses, patients were divided into two groups: those who respond to treatment – whose migraines improved significantly (50% reduction in seizure frequency), and those who did not improve significantly and were assigned to the non-responding group.

Most of the subjects (61%) experienced a significant improvement in their migraines as a result of the use of cannabis and, accordingly, were assigned to the treatment responders group. Patients in the Respondent Treatment Group not only suffered from migraines on a daily basis, they also used significantly less painkillers from the opioid and triptans group compared to the unresponsive group.

Interestingly, there was no difference in the average monthly cannabis dose of the two groups (about 30 grams per month) or the subjects’ consumption frequency (about 5 times a day), so dose differences cannot explain why cannabis helped the migraine group with migraines but Didn’t help the unresponsive group.

Accordingly, the researchers hypothesized that the difference was not in the amount consumed, but in the type or strain of cannabis consumed, and the concentration of the various components in it.

The study also focused on new cannabinoids which might alleviate headaches

In the next phase of the study, the researchers performed a chemical analysis of the medical cannabis strains consumed by the ‘responders’ and the medical cannabis strains consumed by the non-reactants, and compared them. 

It was assumed that differences in the active components between cannabis consumed by the ‘responders’ and those who did not respond were the ones that caused one group to experience migraines as a result of the use of cannabis, and the other group did not.

Because patients commonly diversify and purchase different cannabis strains that they consume at different doses, statistical analyzes have failed to identify specific cannabis strains that are responsible for differentiating between the ‘responsive’ and ‘unresponsive’ groups. 

Furthermore, the researchers had to do a complete chemical analysis of each and every single one of the medical cannabis strains consumed, and then calculate a total monthly average of each of the active ingredients for each patient, out of the total strains consumed.

Through these complex analyzes, they found that there was no significant difference in the monthly dose of known cannabinoids (THC, CBD, etc.) between the ‘reactants’ and the ‘unresponsive’, but there was a significant difference between the doses of two known cannabinoids.

The combinations of strains consumed by the responding group, those who experienced migraine improvement, contained a significantly higher (3.4-fold) concentration of the unknown cannabinoid ‘ms_373_15c’. In addition, the cannabis strains consumed by the unresponsive group contained a significantly higher (5-fold) concentration of other unknown cannabinoids – ‘ms_331_18d’.

In other words, the results indicate a connection between two components of cannabis and migraines, with one being positive (relieving migraines) and the other being negative (preventing and possibly even aggravating migraines).

The concentration of both unrecognized cannabinoids was relatively low across all cannabis strains tested, reaching only 0.28% for the best cannabinoid (ms_373_15c) in the strain containing the most and only up to 0.11% for the bad cannabinoid (ms_331_18d).

However, the potency of these cannabinoids is still unknown, and they may be much lower than those needed for THC and CBD, as was found in the case of another recently discovered cannabinoid, THCP, which is 33 times stronger than THC in Cannabis.

The discovery of these cannabinoids now selectively enriches strains rich in them to create new strains for future studies on migraines, which contain much higher concentrations of the good cannabinoid ms_373_15c and much lower concentrations of the bad cannabinoid ms_331_18d.

Further research must be done in order to prove the potency of cannabinoids

Researchers also noted that because this is an adaptive study, causation cannot be deduced from it, which means that the cannabinoid ‘ms_373_15c’ is not really good for migraines and the cannabinoid ‘ms_331_18d’ is really bad for them because there may be another variable that is not detected.

For example, strains rich in cannabinoid “good” ms_373_15c are naturally also rich in any other undiscovered cannabinoid, called X. In this case, X may be the ingredient in cannabis that relieves migraines, and not ms_373_15c.

On the same principle, strains rich in bad cannabinoid ms_331_18d may naturally also be rich in some other undiscovered material, called Y. In this case, Y may be a cannabis component that aggravates migraines, not ms_331_18d.

The researchers noted that in order to know for sure whether these two cannabinoids directly affect migraines or whether they are indirectly linked as described above, further studies should be conducted to examine their direct effects on humans in controlled clinical trials.

“The results shed light on the beneficial effects of medical cannabis on migraines, and are aimed at future studies to focus on cannabis strains that contain high or low concentrations of cannabinoids mentioned in this study,” the researchers concluded. “If further studies corroborate the results we have received, this may lead to the addition of migraines as an approved means for obtaining a medical cannabis license in Israel.”

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First published in קנאביס, a third-party contributor translated and adapted the article from the original. In case of discrepancy, the original will prevail.

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