Hemp for Headache: An In-Depth Historical and Scientific Review of Cannabis in Migraine Treatment

Cannabis, or ‘‘marijuana,’’ has been employed in various forms throughout the millennia for both symptomatic and prophylactic treatment of migraine. This document examines its history of medicinal use by smoking and other methods in ancient cultures, including the Chinese, Indian, Egyptian, Assyrian, Greek and Roman, as well as in the Islamic world, and its subsequent adoption by Renaissance and Industrial Age Europeans. The most prominent physicians of the age in the century between 1842 and 1942 preferred cannabis to other preparations in migraine treatment, and it remained part of Western pharmacopoeias for this indication throughout the period. The writings of this era are examined in great detail in an effort to emphasize useful medical documentation that has subsequently been forgotten. In modern times, ethnobotanical and anecdotal references continue to support the efficacy of cannabis for headache treatment, while biochemical studies of THC and anandamide have provided scientific justification for its use via anti-inflammatory, serotonergic and dopaminergic mechanisms, as well as by interaction with NMDA and endogenous opioid systems. These are examined in detail. The author feels that this collective evidence supports the proposition that experimental protocols of cannabis usage in migraine treatment should go forward employing modern controlled clinical trials. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: 2001 by The Haworth Press, Inc. All rights reserved.] Ethan Russo, MD, is Clinical Child and Adult Neurologist, Clinical Assistant Professor of Medicine at the University of Washington and Adjunct Associate Professor of Pharmacy, University of Montana, 900 North Orange Street, Missoula, MT 58902 (E-mail: [email protected]). Journal of Cannabis Therapeutics, Vol. 1(2) 2001 2001 by The Haworth Press, Inc. All rights reserved. 21 JOURNAL OF CANNABIS THERAPEUTICS 22