This is a difficult question to answer as what is good for one person is not necessarily the right choice for another. I am going to point you to several links within HelloMD that other medical patients have found extremely helpful.
In this article our Dr. Frye discusses what she feels is the right way to approach the treatment of migraines with cannabis:
And here is a question I answered recently on this same topic:
Migraines are extremely common but the reason why people get them differs. The use of cannabis for treatment is highly individual. I am not a doctor and this only represents my opinion and the research I have done. I hope this helps!
I actually wrote an answer to this many months ago and you can find it if you do a search for migraines. If you consider adding high CBD/ low THC tincture twice daily to your plan, your migraines should start to reduce in frequency and severity the longer you use CBD. You may still experience breakthrough migraines but CBD will tend to get rid of about 90% of your migraines. Migraine sufferers are very chemically sensitive. Migraine sufferers tend to get depression if they breathe chemicals they’re allergic to, I call it a migraine in your emotions. We also get irritable bowel syndrome when we eat foods were allergic to and we get neck pain that must be interrupted in order to get rid of the migraine so always having CBD salve helps. Migraine sufferers must eliminate free glutamate from their diet since free glutamate’s are very neurologically toxic. Consider reading www.truthinlabeling.org for list of free glutamate’s. It is always a good idea to get your genetic chart to see if you have a methylation problem in your neurotransmitters, vitamin D receptors or in your
MAO-A receptor so a dietary and supplement program can be designed that will help you get well.
We have many patients who find great success using Moxie Meds CBD-rich tinctures to address migraines. If you have low(er) tolerance or are new to cannabis and attempting to avoid psychoactive effects, I would suggest starting with 1-2 drops of our Recovery 4:1 formula. If you consume THC or are willing to accept some psychoactivity or "high", 1-2 drops of our Relief 1:1 may be a better option. Generally speaking, an even balance of CBD to THC provides the strongest analgesic effects but the "side effects" of psychoactivity are not acceptable for all patients so it depends on your individual needs. Ingesting our medications under the tongue (a sublingual dose) will provide the fastest therapeutic effects and is also discreet and tastes good!
There was a recent study, a retrospective chart review rather than a clinical trial, which showed promising results – the most significant finding was that cannabis drastically reduced the number of migraine headaches from 10.4 to 4.6.
Further, a very recently performed clinical trial showed that those who received a 200mg dose each day for three months experienced significantly less pain–about 55% less (lower doses didn’t provide the same amount of pain relief.)
Additionally, there is a plethora of anecdotal evidence indicating cannabis as an effective treatment of migraine headaches – effectively reducing the pain, duration and frequency of the migraine headaches.
(for the short answer, skip to the ‘comment’)
There was a recent study, a retrospective chart review rather than a clinical trial, which showed promising results – the most significant finding was that cannabis drastically reduced the number of migraine headaches from 10.4/month to 4.6/month.
Further, a very recently performed clinical trial showed that those who received a 200mg dose each day for three months experienced significantly less pain–about 55% less; smaller doses helped to a lesser degree.
There is also a plethora of anecdotal evidence indicating cannabis as an effective treatment for migraine headaches – effectively reducing the pain, duration and frequency of the migraine headaches.
I receive plenty of positive input from patients regarding CBD’s effects on migraine headaches. However, rather than CBD, the relevant research centers around THC’s role in migraine headache relief.
The understanding of migraine pathophysiology has evolved from the belief that migraine headaches are a vascular disorder, to evidence that better defines migraines as a neurogenic disorder associated with secondary changes in brain perfusion.
THC has been shown to, independant of vasocontsriction (blood vessel narrowing), reduce neuropathic pain. THC also increases cerebral serotonin levels which leads to vasoconstriction (blood vessel narrowing) – the same mechanism of action of sumitriptan (Imitrex).
My colleagues have given some terrific answers for treatment of migraine, including recent research as to the etiology/ causes of migraine. There have been recent papers in the literature that surmise that migraines should be categorized with fibromyalgia and Irritable bowel Syndrome as manifestations of Clinical Endocannabinoid Deficiency Syndromes (CEDS). It sounds like multiple suggestions have been given out for varying CBD vs THC ratios (although Dr. Kim has also mentioned that much of the data involving migraine treatment with cannabis has looked at THC levels). In general, I try to have patients avoid smoking/ combusting plant material as the carbon monoxide and other chemicals produced might be headache inducers for a fair amount of patients; in general I tell patients that a vape pen doesn’t have the same headache risks as a pipe/ water pipe/ joint. If patients are looking for a cannabis delivery method that doesn’t involves smoke/ vapor (if patients want to eschew all inhalation methods), pts may also like tincture drops which have been reported to be fast acting though perhaps not quite as fast as inhalation. Pt’s have reported that cannabis tincture drops, diluted in warm non-caffeinated tea, drink, or hot soup can see onset of action within 10 minutes, relatively quick enough to address the migraine headache symptoms. Given the sudden and painful nature of migraine and other headaches, I always advise patients to have a healthy ad-mixture of CBD and THC