Migraine cannabis

Roffman RA, Barnhart R Assessing need for marijuana dependence treatment through an anonymous telephone interview. Int J Addict 22 639-631, 1987 Russo EB Clinical endocannabinoid deficiency (CECD) can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions Neuro Endocrinol Lett 25(1-2) 31—39, 2004... 

Cannabis, also called marijuana, whether ingested or smoked, has a long history of reportedly safe and effective use in the treatment and prophylaxis of migraine. 

Cannabis, delivered by pyrolysis, in the form of a marijuana cigarette, or joint, has the hypothetical potential for quick and effective parenteral treatment of acute migraine. 

Cannabis, or marijuana, has been used for centuries for both symptomatic and prophylactic treatment of migraine. It was highly esteemed as a headache remedy by the most prominent physicians of the age between 1874 and 1942, remaining part of the Western pharmacopoeia for this indication even into the mid-20th century. Current ethnobotanical and anecdotal references continue to refer to its efficacy for this malady, and biochemical studies of THC and anandamide have provided a scientific basis for such treatment (Russo, 1998). 

Sir William Brooke O Shaughnessy introduced Indian hemp to the West in 1839. William Brooke O Shaughnessy entered the service of the East India Company in 1833 as assistant surgeon. He studied the botany and chemistry of herbs used in oriental medicine and incorporated some into his edition of the Bengal Pharmacopoeia published in 1842. One of these herbs was cannabis, or Indian hemp. His medical treatise recommended an extract from the plant for patients with rabies, cholera, tetanus, and infantile convulsions. Until the end of the 19th century prominent physicians of Europe and North America advocated cannabis extracts for the prevention and symptomatic treatment of migraine headache. 

Between 1874 and 1942 it was highly esteemed as a headache remedy by most prominent physicians of the age. Although the American Medical Association vigorously opposed the action, cannabis became essentially illegal in 1937. Whether or not the plant became a scapegoat for a perceived social problem, research funding was curtailed. In 1941, preparations of cannabis were dropped from the United States Pharmacopoeia (USP) and the National Formulary. Yet a year later, the Journal of the American Medical Association advocated that oral preparations of cannabis be prescribed for the relief of menstrual migraine. 

Russo, E., Cannabis for migraine treatment the once and future prescription An historical and scientific review, Pain, 76, 3-8, 1998. 

Throughout history, Cannabis has been appreciated as a healing herb. By the time of Christ it was used in India and China for the relief of pain, reduction of fever, surgery, stimulation of appetite and treatment of diarrhea, dysentery, bronchitis, migraine, insomnia and a variety of neurological diseases. Between 1840 and 1900, more than a hundred contributions were made to the Western medical literature that recommended Cannabis for one ailment or another. 

Topical application of anandamide to rabbit cerebral arterioles at low concentrations caused a dose-dependent dilation [62]. This observation may be related to the use of cannabis in the past in migraine. 

Cannabis and some cannabinoids relieve pain. However, the therapeutic doses are essentially equivalent to the doses that cause CNS effects and, except in very specific conditions (possibly migraine) they are of limited use. Although several companies have produced a large number of derivatives, as previously reviewed in this series [1] and elsewhere [105,107] the situation has not changed. No practical separation of activity has been achieved, except with the synthetic cannabinoid HU-211 (see below) which does not bind to either CBi or CB2. Hence most of the work reported in the last decade deals mainly with the pharmacology of pain reduction by cannabinoids, rather than with drug discovery and development. 

Cannabinoids are a specific class of psychoactive compounds present in Indian cannabis (Cannabis sativa), including about 60 different molecules, the most representative being cannabinol, canna-bidiol and several isomers of tetrahydrocannabinol. Knowledge of the therapeutic activity of cannabis dates back to the ancient dynasties in China, where, already 5,000 years ago, cannabis was used for the treatment of asthma, migraine and some gynaecologic disorders. Said use later became so established that about in 1850 cannabis extracts were included in the US Pharmacopaeia and remained therein until 1947. 

Relief of intractable pain is one of the core historical applications of cannabis. There are many modern anecdotes as to its utility in cancer pain, bone and joint pain, migraine, menstrual cramps and labour pain (Grinspoon and Bakalar 1993). Cannabis has been shown to have a dose-dependent antinociceptive effect on experimental pain in healthy subjects (Greenwid and Stitzer 2000). 

Russo E (2001) Hemp for headache an in-depth historical and scientific review of cannabis in migraine treatment. J Cannabis Ther 1 21-92... 

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