HEADACHES | +40 articles

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Beckley Psytech Explores Psilocybin Treatment for Headache*​

by Jennifer Walker-Journey | Psychedelic Spotlight | 11 Mar 2021

A new study is looking at how psilocybin treatment may help to reduce debilitating short-lasting unilateral neuralgiform headache attacks.​

Psychedelic research company Beckley Psytech announced it has received the green light from U.K. drug regulators to conduct a landmark clinical trial investigating the effects of the psychedelic therapy psilocybin to treat a rare and debilitating headache condition called short-lasting unilateral neuralgiform headache attacks (SUNHA).

SUNHA belongs to a group of headache disorders known as Trigeminal Autonomic Cephalalgias (TACs). It is considered one of the most painful disorders, causing short-lasting headaches that range from severe to excruciating. Those who suffer from SUNHA may have more than 100 attacks a day. An estimated 46,000 people in the U.S., Canada, and the G5 from Europe suffer from SUNHA, for which no treatments are currently approved.

Researchers plan to enroll up to 12 patients with chronic SUNHA to investigate the potential therapeutic benefits of psilocybin, the active ingredients in magic mushrooms. Rather than recording headache data in paper diaries as is typically done in this type of research, participants in the SUNHA study will be using Beckley Psytech’s experimental smartwatch to record the frequency, duration, and severity of their headaches.

“We believe that overall, we’ll be able to capture data more effectively, and this should lead to more robust data on the number and severity of headaches a patient experiences,” says Becky Hutchinson, Beckley Psytech’s commercial director.

Eligible participants will enter a two-week screening during which they will record information about their headaches. Afterwards, patients will receive three low-doses of increasing amounts of psilocybin with five-day intervals between each dose, during which they will continue to record their headache frequency, duration, and severity.

“SUNHA is a crippling condition for which there is very limited research and no currently approved medications,” says Dr. Fiona Dunbar, Beckley Psytech’s Chief Medical Advisor. “We believe that psychedelic medicine has the potential to make a significant difference to the quality of life of patients suffering with this disease, and are very excited to receive approval for our clinical trial and to further investigate the safety profile and efficacy of psilocybin as a treatment.”​

*From the article here :

Ketamine Therapy May Help Slow Progression of ALS

New research is looking at ketamine therapy as a potential aid in slowing the deadly disease ALS, amyotrophic lateral sclerosis.

psychedelicspotlight.com

 

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Psychedelic Therapy for Migraines*

by Amelia Walsh & Dr. Lynn Marie Morski, MD, Esq | PSYCHABLE | 27 Feb 2022

Migraine headaches are chronic and debilitating. The most basic functions of life may be put on hold, sometimes costing sufferers the experiences that cultivate joy, careers, and opportunities to succeed personally.

There are conventional medicines and treatments for migraines, of course. But in treatment-resistant cases where they have failed to be sufficiently effective, researchers are aware of the need for new types of treatment.

Psychedelic therapy for migraines is one of several options. Read on for more information about migraines and to learn about the potential effects psychedelic therapy might have in terms of addressing symptoms.

What are migraines?

Migraines do cause head pain, but they are different from the common headache.

In addition to severe pain, migraines can cause stomach upset, nausea, dizziness, or disorientation, render ordinary levels of light or sound intolerable, disrupt vision, as well as a number of other difficult symptoms.

What causes migraine headaches?

Migraine headaches are likely a product of genetics, though there are external triggers that influence the frequency and likelihood of onset.

Lifestyle choices like diet, sleep habits, exercise, and management of mood and anxiety can all play a part in how often migraines occur and how severe they are.

Sometimes, there is an underlying medical condition like sleep apnea or an issue with tension in the jaw joint that can trigger the onset of a migraine. Changes in pressure fronts related to weather and shifting hormone levels might also be to blame in some cases.

What are the phases of migraines?

Migraines typically operate on a timeline, meaning there are phases to the attack defined by certain symptoms.

Pre-migraine symptoms

The duration of the pre-migraine (prodrome) phase ranges from a few hours to several days. One might be irritable, have trouble sleeping, feel more sensitive to stimuli such as light and sound, have depression or nausea, or even experience muscle stiffness and problems with concentration.

Aura phase

Not everyone who suffers from migraines experiences the aura phase, and it does not occur with every attack for those who do. Symptoms typically involve the loss or distortion of vision, including blind spots and flashes of light.

Headache phase

Lasting anywhere from a few hours to 3 days, the headache phase is characterized by pain on one side of the head or both. This pain can feel anywhere from moderate to severe and intolerable. It can be accompanied by anxiety, light and sound sensitivity, nausea, and inability to sleep.

Postdrome phase

Many people experience a postdrome phase after a migraine headache, with symptoms such as fatigue, trouble with concentration, and body ache.

Is there a cure for migraines?

While there is no cure for migraines, the symptoms can be treated.

Chronic migraine treatment options tend to focus on prevention by way of lifestyle changes, behavioral therapies, trigger avoidance, and even certain devices that claim to help.

Migraine therapy might include over-the-counter (OTC) and prescription pain medications, but these do not prevent headaches.

Preventative treatments such as botox injections or certain medications like beta-blockers are also available.

Psychedelic therapy for migraines

Studies are currently underway to discover more about how psilocybin (magic mushrooms) and LSD might be effective in the treatment of migraine headaches.

Like several others on the subject, one study suggested that psychoactive substances show great promise in providing relief for those suffering from migraines and cluster headaches. There is evidence that just a single treatment of psilocybin could have lasting positive results with a low occurrence of negative side effects observed in the controlled study population.

Effects of microdosing psychedelics for migraines

Microdosing (taking very small amounts of psychoactive substances on an infrequent but consistent basis) has seemed to help many suffering from migraine and cluster headaches to live more functional, joyful, and productive lives with fewer incidents of attack.

An initial study found that participants (both clinical and non-clinical) reported a more positive mood and decreased depression, increased energy, feeling creative, and being more effective at work when given a microdose of either LSD or psilocybin every 3 days over a period of 18 months.

Among the general results reported is the relief of migraine symptoms, though the extent or nature of alleviation is not specifically known. Additional research is needed to understand the suggested benefits and risk factors of psychedelic treatment for migraines.

*From the article here :

Psychedelic Therapy for Migraines

Medical Editor: Dr. Lynn Marie Morski, MD, Esq Migraine headaches are chronic and debilitating. The most basic functions of life may be put on hold,

psychable.com

 

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Single dose of psilocybin may treat migraines

by Stephen Johnson | BIG THINK

Can the main psychoactive ingredient of magic mushrooms help treat the world's sixth most debilitating illness?​

• Migraines afflict more than ten percent of the U.S. population, yet treatments are often unreliable and there is no cure.​
• The new study involves giving migraine sufferers a placebo and, two weeks later, a single dose of pure synthetic psilocybin.​
• The results showed that participants reported significantly fewer migraines in the two weeks after the study.​

Psychedelics research is enjoying a renaissance. In recent years, studies have shown that hallucinogenic drugs like LSD, psilocybin, and MDMA seem to have powerful therapeutic effects on conditions including major depression, anxiety, and addiction disorders.

One unique aspect of psychedelics is that taking a single moderate dose can yield long-lasting therapeutic benefits for people with certain conditions, such as cancer patients with depression and anxiety.

Now, new research published in Neurotherapeutics suggests these outsized benefits may also apply to people with migraines. The evidence is preliminary but promising, and it could open up new areas of research for treating migraines, which are often chronic and debilitating.

A painful, debilitating condition

Migraine affects more than 10 percent of the U.S. population and it’s ranked as the world’s sixth most debilitating illness. Treatments can alleviate migraine symptoms, but efficacy varies from person to person, and even treatments that do work sometimes produce unpleasant side effects. There’s currently no cure for the condition.

What’s a migraine like?

“Put your finger on your temple and imagine drilling it inside your head,” a 29-year-old woman named Heather once told Prevention. “My migraines feel like a screwdriver in there, in that one spot, always on my left side and in my left eye. I get a burning sensation throughout my body and in my jaw. Everything becomes sensitive to the touch, like my muscles are on fire.”

Treating migraines

Migraine treatments can be either preventive or abortive, and they range from prescription drugs, to over-the-counter medications like Advil Migraine, to home remedies like yoga or taking a hot shower. Psychedelics are another sort of home remedy. For decades, anecdotal evidence has suggested that drugs like LSD and psilocybin may help prevent or alleviate migraines, possibly because they’re pharmacologically similar to migraine medications like dihydroergotamine, noted the researchers behind the new study.

To put that anecdotal evidence to the test, the researchers designed a placebo-controlled study in which they gave migraine sufferers a moderate dose of pure synthetic psilocybin. The participants included seven women and three men, all adults, who regularly suffered at least two migraines per week. All participants were free of any serious psychiatric or medical diseases and hadn’t abused drugs within three months prior to the study.

To track migraine activity, the participants documented their headache attacks in a journal for six weeks, starting two weeks before the study and stopping two weeks after. The study was divided into two sessions, one of which involved taking a small dose of pure synthetic psilocybin.

“In the first experimental session, all subjects received an oral placebo capsule, and in the second experimental session, all subjects received an identically appearing oral psilocybin capsule,” the researchers wrote. “In this design, each subject acted as his own control and placebo was given first so that the potential long-term effects of psilocybin, if given first, would not interfere with placebo treatment, if given second.”

In the hours after each session, the participants answered questions about any psychedelic effects they might have been experiencing. No participants reported any adverse effects.

Outsized benefits

In the two weeks after taking the psilocybin, most participants did report significant decreases in migraines compared to baseline and the placebo session.

“The percentages of subjects who had at least 25, 50, and 75% reductions in weekly migraine days were as follows: 80, 50, and 30% after psilocybin, and 20, 20, and 0% after placebo, respectively,” the researchers wrote. “Psilocybin and placebo significantly differed at the level of at least 25% reduction.”

Interestingly, these reductions weren’t correlated with how strongly the participants felt the psychedelic effects of psilocybin. That suggests migraine sufferers don’t need to take a large dose of psilocybin and therefore experience its intense and potentially unpleasant hallucinogenic effects to reap the benefits from it.

But perhaps most promising was that the therapeutic effects lasted at least two weeks after a single dose, differentiating psilocybin from other migraine medications that need to be taken regularly. Still, the researchers noted more research is needed:

“While encouraged by the findings in this exploratory study, before this approach could be used clinically, it is imperative that additional controlled investigations be completed in order to understand psilocybin’s full capacity to suppress migraine, as well as its long-term safety and tolerability. To verify the present findings, it will be necessary to replicate the results of this study in a larger sample under a fully randomized design. Studies with a dose range will inform on whether the effects of psilocybin in migraine are dose dependent.”

Single dose of psilocybin may treat migraines

Can the main psychoactive ingredient of magic mushrooms help treat the world's sixth most debilitating illness?

bigthink.com

 

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Psilocybin & migraine: First of its kind trial reports promising results

by Rich Haridy | NEW ATLAS | 1 Apr 2022

A first-of-its-kind exploratory study, led by researchers from Yale School of Medicine, has found a single dose of the psychedelic psilocybin can reduce migraine frequency by 50 percent for a least two weeks. The preliminary trial was small, with follow-up work necessary to validate the results, but the promising findings suggest great potential for psychedelics to treat migraines and cluster headaches.

Back in the 1960s, during the height of the first wave of psychedelic science, one of the more compelling research avenues was the potential for drugs such as LSD and psilocybin to treat headaches. Initial studies at the time seemed to suggest psychedelic drugs that activate 5-hydroxytryptamine 2A (5-HT2A) receptors could significantly reduce headache burden in chronic migraine sufferers.

Of course, all this research froze by the early 1970s as psychedelic drugs were criminalized and rendered taboo. It wasn’t really until the early years of the 21st century that the research restarted, and most modern psychedelic research has primarily focused on the drugs as adjuncts to psychotherapy, targeting conditions such as depression, addiction and PTSD.

Although official psychedelic investigations were in a state of deep freeze, out in the real world people continued to experiment with these drugs, self-treating for a number of conditions. Several surveys of these real-world applications revealed an abundance of cluster headache and migraine patients experimenting with LSD and psilocybin.

A new study, published in the journal Neurotherapeutics, is offering the first double-blind, placebo-controlled, cross-over study on the effects of a moderate psilocybin dose on migraine frequency and severity. The research is only preliminary and small but its results are deeply encouraging.

Ten migraine sufferers were recruited for the trial. Each subject completed two sessions, one with a placebo and one with a moderate psilocybin dose. Headache diaries were used to track headache frequency and severity in the two weeks leading up to, and following, each experimental session.

“Compared to placebo, a single administration of psilocybin reduced migraine frequency by about half over the two weeks measured,” explains corresponding author on the new study Emmanuelle Schindler, in an email to New Atlas. ”In addition, when migraine attacks did occur in those two weeks, pain intensity and functional impairment during attacks were reduced by approximately 30 percent each.”

Perhaps the most intriguing finding from this small study was the lack of any correlation between the subjective strength of the psychedelic experience and the therapeutic effect. Prior trials using psilocybin to treat depression or addiction have suggested the overwhelming magnitude of a psychedelic experience seems to be fundamentally entwined with its therapeutic efficacy. So essentially, the more powerful the experience the better the result.

But unexpectedly, this migraine/psilocybin trial did not detect that association. In fact, those subjects reporting the highest scores on a self-reported altered state of consciousness scale showed some of the smaller reductions in migraine burden.

What this intriguingly suggests is that, in the case of psilocybin for migraine, it may be possible to separate out the drug's psychotropic effects from its therapeutic effects. This could be achieved either by exploring microdoses and sub-hallucinogenic doses, or even homing in on the mechanism by which the drug is helping prevent migraines and finding a new way to pharmacologically target it.

“This is definitely a finding we’re interested in exploring further,” says Schindler. “If these outcomes are confirmed to be independent, it suggests that the migraine-suppressing effects do not involve the same systems that cause the acute changes in sensation and perception. Psilocybin has some chemical and pharmacological similarities to existing migraine medications that are not psychedelic, so we plan to investigate its therapeutic effect in this context.”

It is important to understand the limitations of these new findings. This is a small exploratory study, designed to uncover potential signals that are worthy of more robust investigation. The two-week follow up, for example, offers no indication as to the long-term efficacy of this kind of therapy. This is something Schindler suggests will be closely studied in future research.

Moving forward, Schindler is cautious not to overstate her team’s findings but she does say the results are exciting. Not only does this research offer signals psychedelic compounds could meaningfully help those suffering from debilitating migraines, but the study offers novel insights into the still-unexplained physiological causes of chronic headache disorders.

Lots of questions still need to be resolved before any kind of clinical treatment can come from this research but Schindler and colleagues are already working on the next steps, with longer follow-up periods and greater focus on different dose effects.

“I have a new migraine study starting soon and I’m also currently studying post-concussion headache, which often resembles migraine,” adds Schindler. “I’m not aware of any other groups investigating psilocybin or related compounds in migraine, though cluster headache is currently being studied, not only by my group, but also Swiss and Danish researchers.”

The study was published in the journal Neurotherapeutics.

Psilocybin & migraine: First of its kind trial reports promising results

A first-of-its-kind exploratory study, led by researchers from Yale School of Medicine, has found a single dose of the psychedelic psilocybin can reduce migraine frequency by 50 percent for a least two weeks. The preliminary trial was small, with follow-up work necessary to validate the results,…

newatlas.com

 

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Psychedelics for Treatment of Suicide Headaches

Neurologists need to understand the phenomenon of using psychedelic drugs for cluster-busting and advocate for appropriate research.

Cluster headache (CH) has the dubious distinction of being the most painful disorder known to humankind: topping cancer, broken bones, childbirth and third-degree burns1 and has been referred to as the suicide headache because suicidal ideation occurs in 55% of patients (Case). The International Clasification of Headache Disorders, 3rd edition (ICHD-3) describes CH as side-locked, periorbital pain lasting 15 to 180 minutes, with autonomic features such as ptosis, nasal congestion, and a bloodshot eye. Fortunately, CH is uncommon, striking an estimated 0.1% of persons in the US. Approximately 17% of patients with CH (~1 in 6) have the chronic variant, with no break in the unrelenting attacks. To say that chronic cluster is the worst version of the most painful condition known only begins to hint at the agony.

Case presentation. The Suicide Headache

The term suicide headache is so often repeated it risks sounding cliché but not for Glenn R. A soft-spoken middle-aged machinist, 2 years ago Glenn, despite having no background in firearms and no previous desire to use guns, completed the firearm safety course and bought a semiautomatic handgun. Married to his high school sweetheart with 2 young kids and a job that paid the bills, Glenn had few complaints, but he needed a way out. The word headache, as it applied to the horror that visited him in the darkest hours of each morning, was a joke. This was no headache. It was hell on earth, the worst torture imaginable, a beast within: a suicide headache.

Glenn's first 2 attacks of what he learned were cluster headache had him arrested. When the first one struck, he was drinking tequila, bumming smokes, and celebrating a coworker's recent nuptials. When his left eye exploded he was gobstruck; sweating, panting, pacing like a caged animal, he swung his arm like a wrecking ball into a mirrored wall, shattering glass and prompting a call to the police. In the squad car, he writhed, handcuffed and tearing. Intoxication with PCP was suspected, and in the emergency department, after his belt and shoe laces were confiscated, he waited in a padded room. The terror abruptly ceased 90 minutes after it began. Confused, labs devoid of illicit substances and head CT results normal, Glen was discharged, with neither instructions nor follow-up.

At 2:11 the next morning. the beast returned. Glenn screamed, rocked back and forth, and slammed his head into the headboard repeatedly. His panicked wife dialed 911. This time, a neurology resident—who was admitting a stroke patient when Glenn was brought in—saw 3 security guards whisk an agitated, handcuffed guy the size of a side of beef past her. She noticed the drooping right eye, the tearing, and the bloodshot iris. She stopped what she was doing, asked the nurse for sumatriptan, 6 mg, stat, and followed Glenn into the padded room.

Glenn found a headache specialist and for 9 years, he could manage the cluster headaches that struck twice a year. If he jumped on verapamil, prednisone, and occipital nerve blocks at the start of a cycle, got his insurance to cover high-flow oxygen, and finagled enough injectable sumatriptan, he could fight the beast for a month or so and beat it down.

Eventually, 3 years later and 12 years after the first headache, Glenn's treatment plan stopped working and chronic cluster headache set in. The suicide headache came to stay. The medicines stopped working. A coworker suggested marijuana, but that intensified the pain. Glenn tried 20 or more pills, and all types of alternative treatments, but nothing worked. Desperate and hopeless, he concluded the gun was the only option left.

Treatments approved and being studied

There is high-quality evidence for use of sumatriptan injection, zolmitriptan nasal spray, and high-flow oxygen inhalation to treat patients with acute CH. For preventive treatment, there is less evidence. Although ipsilateral occipital nerve block alone is an American Headache Society (AHS) level A recommendation, high-dose verapamil is the most commonly used preventive; lithium and topiramate remain mainstays, despite inadequate evidence. Newer therapeutic options include neurostimulators (eg, noninvasive vagal nerve stimulator [VNS] [Gammacore; Electrocore, Basking Ridge, NJ] shown effective for episodic CH or an investigational implanted sphenopalatine ganglion [SPG] stimulator [Pulsante; Autonomic Technology, Mountain View, CA] for acute treatment of chronic CH). Monoclonal antibodies to calcitonin gene-related peptide (CGRP) are also being studied for the treatment of patients with CH and may have efficacy in prevention of episodic but not chronic CH.

The alternative some patients use and may not speak about

More than 25% of patients with CH find that neither medicines, nerve blocks, oxygen, nor neurostimulators work for the crushing, unrelenting agony of this most painful of all maladies. A sizable subset of these patients, driven to the brink of suicide, will go to any length, including taking an illegal substance that may risk their health, job, and freedom, to break free of the torment that is CH.

Increasingly, patients with CH are turning to psychedelics (eg, lysergic acid diethylamine [LSD] or psilocybin), and treating themselves with hallucinogenic substances, although often in subhallucinogenic doses. For a variety of reasons, they may not be forthcoming with their headache specialist about this. It is therefore incumbent upon neurologists and others who treat patients with CH to know that what is termed busting, treating CH with psychedelics, is widely known, well-accepted, and frequently practiced by those with CH for whom all else has failed.
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LSD and Psilocybin - A Brief History

The first recorded neuropsychiatric effects of LSD were reported in 1943 by Albert Hoffmann, a young chemist at Swiss pharmaceutical giant Sandoz, who tested hundreds of serotonin-based compounds, determined to discover a safe and effective circulatory and respiratory stimulant. After ingesting a 0.25-mcg dose, he had an experience many consider the world's first acid trip of, “unprecedented colors and plays of shapes; kaleidoscopic, fantastic images alternating, variegated, opening and then closing themselves in circles and spirals, exploding in colored fountains, rearranging and hybridizing themselves in constant flux.”

Psilocybin is a naturally occurring hallucinogenic tryptamine similar to LSD, found in over 180 species of small, nondescript mushrooms in the psilocybe family. For millennia, indigenous people throughout Mexico and Central America have consumed these in religious ceremonies. Albert Hoffmann isolated pure psilocin (the active metabolite of the prodrug psilocybin) in 1963.

Both LSD and psilocybin were studied for treatment of people with a number of psychiatric conditions, including severe depression, alcoholism, and posttraumatic stress disorder throughout the 1950s and 1960s. Then came the Age of Aquarius, counter-culture, and Timothy Leary, a Harvard psychologist who encouraged widespread recreational use of psychedelics, urging his followers to “turn on, tune in, and drop out.” Federal authorities, reacting to a perceived drug epidemic, outlawed both psilocybin and LSD, designating each a schedule 1 substance: meaning high abuse potential and no proven medical value.

Biochemistry of Psychedelics

Psychedelics like LSD and psilocybin stimulate serotoninergic and dopaminergic receptors (Table),9 and have varying routes of administration and pharmacokinetics with half-lives ranging from seconds to hours. At sufficient doses, psychedelics disrupt the default mode network (DMN), a collection of neural structures discovered by Raichle and colleagues in 2001.10 The DMN, which switches on when the brain is resting and not attending to external stimuli, is believed to be the seat of our ego, or sense of self. Hallucinogens dissolve the line between self and nonself and distort concepts of linear time. It has been theorized that psychedelics allow the user to see, hear, smell, and taste a far richer palette of sensory input than the brain would normally allow. Functional magnetic resonance imaging (fMRI) studies of volunteers who have ingested LSD or psilocybin show greatly enhanced functional connectivity that seemingly allows brain areas to signal to other areas that they normally wouldn't, accounting for such effects of audiovisual synesthesia, derealization, and depersonalization known as tripping.
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The ring structure of LSD is similar to ergotamine-based headache-relieving compounds such as methylergonovine and methysergide, and psilocin is chemically nearly identical to serotonin.12 Sumatriptan, a sulphonated indole, is structurally similar to the hallucinogen dimethyl tryptamine (DMT). Like psilocybin, DMT has been used in religious ceremonies for centuries; when DMT is combined with a plant-based monoamine oxidase inhibitor (MAOI), it is called ayahuasca. Because DMT is often inhaled rather than ingested, peak plasma concentrations are reached in seconds.

Psychedelics and Cluster Headache

The similarities in biochemistry make it unsurprising that indolamines (eg, ayahuasca, DMT, D-lysergic acid amide [LSA], LSD, psilocybin, and the nonhallucinogenic 2-bromo-LSD [bol-148]) are anecdotally reported to have efficacy for treating people with CH. Social media has raised awareness of this and even somewhat of a rush of desperation by patients with CH toward psychedelics for relief. Bob Wold, who had CH for 30 years, experimented on himself with great success and founded the nonprofit Cluster Busters in 2002 with the goals of spreading the psychedelic gospel.

In a study of 53 patients who practiced busting with LSD or psilocybin, colloquially termed clusterheads, investigators concluded that use of either compound appeared to stop attacks, extend breaks between cycles, and even stop cluster cycles in a majority of users (Case Resolution). When taken at microdoses, side effects were almost nonexistent.

Case resolution. From contemplated suicide to father of the bride

Glenn learned about psilocybin-containing mushrooms from an online chat room, and he credits them with saving his life. Although he drank a little tequila before his clusters became chronic and smoked some marijuana in high school, Glenn was a pretty straight arrow. He read articles describing how hallucinogenic doses of LSD cured refractory alcoholism; learned that Bill Wilson, founder of Alcoholics Anonymous, credits his sobriety to a life-changing experience with LSD; and saw a New York University study on how use of psilocybin helped terminal cancer patients overcome crippling existential fear of death.

Still, the idea of tripping held no appeal for Glenn; instead, like most patients with CH, he decided to microdose. A simple guy, he just wanted the beast contained, and despite buying the gun, Glenn really wanted to live.

Glenn's first dose was a nonhallucinogenic 500 mg of mushrooms chewed into a bitter pulp and swallowed. That day and the next he was pain free for the first time in years. He took another dose 2 days later and had a delicious 5-day run of pain freedom, and although he did have an occasional shadow—a livable dull bruise around his eye—he had no tearing or eye droop, and no need to bash his arm into a wall. Through trial and error, guided by online resources, Glenn worked out a regimen of 500 mg of mushrooms twice a week at the onset of a cluster cycle (miraculously, his clusters had reverted back to episodic) for 2 weeks. If that didn't abort the cycle altogether, he took another 250 mg twice a week for another month. He found he could usually stop at that point and the cluster cycle would end.

Glenn discovered he enjoyed shooting the gun, but not at his head, and he joined a local gun club where he teaches the firearm safety course once a month. When I last saw him, he was feeling well. His daughter had married a few weeks earlier. He visibly choked up when describing his desperate plan with the gun, and how he never would have experienced his daughter's wedding had it not been for microdosing with psilocybin-containing mushrooms.

The need for adequate research

The major drawback of self-treatment of CH with psychedelics is that most are illegal to possess, and the DEA schedule 1 status makes research nearly impossible, although there is 1 ongoing double-blind study of psilocybin in patients with CH.a By legal necessity, patients treat themselves in the shadows, often without guidance from their headache doctor, who likely has no idea what their patient is doing. In recent years, there has been a loosening of attitudes toward these substances, perhaps in part due to the widespread acceptance of medical marijuana, now legal in 30 states and the District of Columbia.

I recently gave a lecture to the Cluster Headache Support Group at their annual conference in Philadelphia. In addition to covering neuromodulation and CGRP-related treatments, I spoke about psychedelics. I asked attendees to chat with me afterwards and heard story after story of heart-breaking pain dramatically reduced or eliminated by psychedelic compounds. I left convinced that there is just no good reason why these treatments remain illegal for those with CH. To deprive someone suffering this degree of pain a treatment that, while clearly inadequately studied, appears safe and effective, seems cruel.

As with all medicines, when discussing hallucinogens as treatment modalities, caveats abound, and these substances are not for everyone. I would include on a no-fly list: children, pregnant or lactating women, and those with pre-existing significant medical or psychiatric disease, pending further studies if we are ever allowed to do them. As is also true of typical medicines, psychedelics are neither panacea nor cure.

Anecdotally, some patients with CH report no benefit, while a small group appears to feel worse. Clearly, there is much work to be done. We need, on behalf of all those suffering from the suicide headache, rigorous double-blind, placebo-controlled studies to properly determine efficacy, dosing, side effects, and safety.

Summary

Patients experiencing the excruciating pain of chronic CH are often desperate, and the lack of well-designed clinical studies is not enough to stop them from trying something—anything—that might end the pain. The patient we describe here has all the evidence for efficacy he needs: walking his daughter down the aisle.

For the countless other patients out there, let's hope (and advocate) for loosening of restrictions on research into psychedelics, by demoting them to a DEA schedule that will better allow proper research. Then, armed with knowledge derived from rigorous study, and legal access to psychedelics in microdoses, we may one day finally tame the beast, and the suicide headache will be no more.

*From the article (including references) here :

Headache Horizons: Tuning in to Psychedelics for Treatment of Suicide Headaches - Practical Neurology

Neurologists need to understand the phenomenon of using psychedelic drugs for cluster-busting and advocate for appropriate research.

practicalneurology.com

​

 

[mr peabody]

Karlstad University
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Psychoactive substances as a last resort—a qualitative study of self-treatment of migraine and cluster headaches

Martin Andersson, Mari Persson & Anette Kjellgren

Harm Reduction Journal | Springer Link | 5 Sep 2017

Migraine and cluster headache (CH) are prevailing, episodic, often chronic headache disorders that have a considerable impact on the individual and society. Especially, migraine with a prevalence of nearly 15% worldwide is a significant cause of disability and notably burdens medical costs and loss of productivity. Cluster headaches are a rarer but particularly painful and debilitating form of headache disorder with a prevalence around 1 in 1000 individuals. While there are numerous treatment practices for headache disorders, none are ideal and most exhibits unsatisfactory effectiveness, tolerability, or patient adherence. There are presently no pharmacological treatments available specifically developed for CH. The currently used methods originated as treatments for other indications and were found helpful in CH by chance. CH is known to be sometimes resistant to the conventional therapies (around 20% in chronic cases of CH). Considering that CH is one of the most intense and disabling pain conditions known, the urgency of the circumstances has led care providers and patients to try unusual or experimental remedies. However, CH patients sometimes fail to respond also to the more experimental methods used in clinical practice.

Dissatisfaction with conventional therapies and adverse effects can often motivate the use of complementary and alternative medicine (CAM). Also, the general interest in CAM has seen an upsurge over the past decades in both the USA and Europe. There is currently a growing interest and some evidence supporting various complementary or alternative medicine treatments of headache disorders. One controversial, but increasingly reported effective treatment is the use of psychedelic tryptamines like LSD and psilocybin. A few studies, as well as extensive anecdotal support, have indicated the effectiveness of psychedelic tryptamines for the treatment of both CH and migraines. These substances are structurally similar (indole alkaloids) to the triptans currently prescribed for the treatment of CH. Even so, the prescribed non-psychoactive triptans do not abort cluster episodes or prolong remission periods as psilocybin or LSD reportedly does. Schindler et al. state that the combination of high efficiency and low rate of adverse effects observed with the psychedelic tryptamines is not seen in any of the currently used treatments. However, some reports on the non-psychoactive LSD analog BOL-148 have shown equally promising results for the treatment of cluster headache with similarly reported low rates of adverse effects. BOL-148 is currently not available for use in clinical practice.

A few published studies and rich anecdotal supports also indicate the effectiveness of cannabis for alleviating headaches, but to our knowledge, no proper clinical trials are currently available. Historically, cannabis was well-regarded as an acute, as well as prophylactic, treatment for headache disorders and was included in the major pharmacopeias of the second half of the nineteenth century. The illegal status of cannabinoids and psychedelics has critically hindered medical research, and there are currently no blinded studies on headache patients so true effectiveness can be determined. To improve understanding of the effects and possible benefits or harms of scarcely researched substances, Internet discussion forums, and the users’ own accounts of their experiences, have proven to be a valuable source for surprisingly accurate early research data when clinical trials are not available.

Increasingly, the Internet serves as a primary source for information on personal health concerns. In the current digital landscape, patients and caregivers now have easy access to each other and Internet support groups (ISG) are formed around most medical conditions. Almost a quarter of those with long-term conditions reportedly uses the Internet to seek out peers. As the web transformed from the more static and hierarchical structures of the early days to the emergence of a co-creational social media environment, there is an ongoing shift from merely searching for health information to that of reciprocally producing and evaluating content. A corresponding municipally based knowledge production (“citizen science”) is observed in the recreational drug communities online. There is also a considerable overlap between the psychoactive drug discussions and the health communities online as psychoactive drugs sometimes are utilized as attempted self-medication. This overlap is present to a high degree amongst the headache disorder patient groups exploring alternative treatments online as these discussions commonly focus on medicating with various psychoactive substances. In line with our previous drug discussion studies, we applied a similar approach using thematic analysis of forum discussions by sufferers of headache disorders as a basis for the present study.

Discussion

Our qualitative inquiry complements previous studies and illustrates the complex situation of treatment-resistant patients with headache disorders and how self-treatment is conducted. The result provides an insight into why, how, and by which substances and methods sufferers seek relief from CH and migraines. Furthermore, the result gives an appraisal of the potential effectiveness of commonly used substances and treatment strategies, as well as possible adverse effects. The central incentives to seek alternative treatments were described as deep feelings of dejection and despair from trying all available treatment methods from healthcare to little or no success. Also, the result shows how discussion forums are used to find community, support, and understanding in desperate and vulnerable circumstances. A reciprocal accumulation and evaluation of knowledge in this domain through the formation of Internet support groups and the promotion of harm reduction perspectives is also further highlighted through the present study.

Self-treatment with psychedelic tryptamines, primarily LSD and psilocybin, was reported to provide a significant lessening of the frequency and intensity of attacks in many cases of both CH and migraines. A full remission was also prevalently reported for both disorders. However, sufferers typically continued to use a psychedelic substance a few times a year to maintain their condition at a minimum. The findings largely confirm previous research indicating that psychedelic tryptamines appear effective for treatment of both CH and migraines, also in otherwise treatment-resistant patients.

The few individuals reporting no therapeutic effects from psychedelic tryptamines at all had typically only used these substances once or very few times. Therefore, several possible reasons for the lack of beneficial results were discussed on the forum, for example the timing or route of ingestion, dosage, and the potency of the material.

Self-treatment with cannabis was also commonly discussed, but treatment results were highly varying. While some reported acute relief or prophylactic benefits of cannabis use, others experienced a worsening of symptoms or even triggering of episodes. The differing results from using cannabis were discussed on the forums in relation to timing, frequency, and method of administration, dosage, and in particular the strain (type) of cannabis or the quality of the product. Since herbal cannabis consists of many different cannabinoids and other compounds, there might be active substances present potentially helpful for treating these conditions and other compounds exhibiting opposing effects.

Many other types of psychoactive substances, as well as supplements, vitamins, and herbal remedies, were discussed as potential remedies. However, all these were scarcely considered or only used in combination with other measures. Therefore, the effectiveness of these substances and supplements cannot be further addressed in the present study.

Treatment attempts were typically systematic rather than random, often following a particular dosing regimen. Principally, three different approaches or regimens for dosing psychedelic tryptamines were reviewed and recommended: (1) the cyclic “busting” (or “clusterbuster”) method, (2) frequent “microdosing,” or (3) single and occasional “full” doses. Microdosing was sometimes preferred (over “busting” or regular “full” doses) as it did not interfere too much with daily responsibilities and some also described additional beneficial effects like increased optimism, creativity, and awareness of self: “Microdosing alleviated my depression.” Some individuals reported insufficient therapeutic effects from using smaller more frequent doses but described how higher doses, with full psychedelic effects, had significant prophylactic effects for both CH and migraines. However, this population typically did not appear to have any interest in psychoactive effects, which were rather avoided by using sub-psychoactive doses or tolerated by those who acquired higher doses to achieve treatment results. Also, sufferers appeared to rather reluctantly use illegal substances out of sheer desperation and discussed how changes in drug laws or access to certain substances for certain conditions would be highly preferable.

Despite apparent dissatisfaction with established medicine and public policy, the forum discourse entailed scientific references and information from experts and medical practitioners as an addition to sharing personal experiences and reflections. Localized harm reduction perspectives, relevant to the specific type of drug board, have been identified as a key theme in drug-related forum discussions, and this character of content was further observed in the present study. The participant’s personal needs for useful and objectively accurate information appeared to contribute to a collective process that produces relatively high-quality information focused on minimizing harm and to optimize the potential effectiveness of treatment attempts.

A prominent feature of the discussions was the heartfelt reports on the immense suffering and helplessness of CH sufferers who experienced frequent and debilitating pain and found little or no relief using available methods from healthcare. Several reports of misdiagnosis and how this motivated the sufferers to look elsewhere for information and possible relief were present in the data. The following quotation is a good representation of the point of view expressed by the many sufferers and the rationale of using these substances as a last resort: “Cluster headaches are so severe that doctor’s implicit prognosis is suicide or opiate addiction. One dose of LSD can treat this illness for up to a month. Ultimately, cluster headache sufferers who treat their condition with LSD often experience full remission and don’t have to use LSD again. So here we have a remedy that can treat this condition better than any other treatment and can potentially CURE cluster headaches! Yet, we let these patients commit suicide or get dependent on opiates for the rest of their lives.”

The intense and desperate situation expressed by many of the CH sufferers should be noted and taken most seriously as the desolation could sometimes lead to suicide or other harmful measures. It was observed in the present study how this desperation sometimes spurred risky behavior when obtaining and testing various treatment alternatives and how unregulated Internet vendors were used to obtain unknown and possibly harmful substances (NPS). NPS tryptamines like alpha-methyltryptamine (AMT) have caused poisonings with fatal outcome. Several reports in the present study indicated that new and unknown substances (NPS) were used when LSD was hard to obtain. LSD and psilocybin are, when in pharmacological quality, not toxic, and deaths from the direct effects of LSD are unknown. However, when obtaining illicit substances like LSD, the risk of acquiring a mislabeled, adulterated, or impure substance is naturally present. In the present study, no severe adverse effects were noticed from attempted self-medication with these substances, but the long-term effects of such use are not known.

The role of hallucinogenesis (i.e., psychoactive/psychedelic effects) for the therapeutic potential of these substances has previously been addressed by researchers but is not yet fully explained. For example, the non-hallucinogenic ergot derivative, methysergide, was reported to be mostly ineffective for treatment of CH in the present study, and previous studies have indicated similar results. On the other hand, the non-psychoactive ergot derivative BOL-148 was found to be equally effective as the psychoactive counterparts in some studies. Also, the psychedelic tryptamines were often reportedly effective at sub-psychoactive doses, both in the present study and previous studies. The aforementioned would suggest that hallucinogenesis is not needed for therapeutic effects on CH. No self-therapeutic use of BOL-148 was reported in the present study, most likely because of the unavailability of this substance.

*From the article (including references) here :

Psychoactive substances as a last resort—a qualitative study of self-treatment of migraine and cluster headaches - Harm Reduction Journal

Background Treatment resistant cluster headache and migraine patients are exploring alternative treatments online. The aim of this study was to improve comprehension regarding the use of non-established or alternative pharmacological treatments used by sufferers of cluster headaches and...

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A single dose of psilocybin has a lasting therapeutic effect on migraine headache*

by Eric W. Dolan | PsyPost | 18 May 2021

Scientists have started to investigate whether psilocybin, the primary substance responsible for the psychedelic effects of “magic” mushrooms, could be helpful to those who suffer from migraine headache. Their new findings, published in Neurotherapeutics, provide preliminary evidence that the drug could provide long-lasting therapeutic benefits to migraine sufferers.

Anecdotal reports have circulated for years that psilocybin lessens migraine symptoms. But there has been little scientific evidence to back the claims. The newly published research is the first double-blind, placebo-controlled study to examine whether psilocybin affects migraine disease.

“As a headache medicine physician, I see the need for a better understanding of headache disorders, including migraine, and the need for more treatment options. I’ve also studied the neuropharmacology of psychedelics for a number of years and appreciate their ability to help us understand more about the workings of the human brain,” explained study author Emmanuelle A. D. Schindler (@eadschindler), an assistant professor of neurology at Yale School of Medicine.

“When I learned that patients with certain headache disorders reported lasting improvements after just a single or few doses of psilocybin or other psychedelics, it made me wonder whether these drugs couldn’t help us better understand the underlying pathology in headache disorders, as well as serve as a new form of treatment.”

In the study, seven women and three men who suffered from frequent migraines first consumed a placebo capsule. At least two weeks later, they consumed a capsule containing a low dose of psilocybin. Both the participants and the research staff were unaware of which capsule contained the placebo and which capsule contained psilocybin. Two weeks before their placebo dose, the participants started to maintain a daily diary of their headache symptoms. They maintained this diary until two weeks after the active dose of psilocybin.

Schindler and her colleagues found that psilocybin was associated with a greater reduction in the frequency of migraines compared to placebo in the two weeks after capsule ingestion. Psilocybin was also associated with reductions in both headache pain severity and migraine-related functional impairments.

“This study is very preliminary and does not serve as a guide for how to manage migraine with psilocybin, but it does offer some important information. In this study, the effects of psilocybin on migraine (the disorder, not a single attack) were investigated. Psilocybin had a lasting effect on migraines, similar to the effect of taking a daily preventive medication, but psilocybin was only given a single time in this study,” Schindler told PsyPost.

“There is no other oral treatment that can do this. Furthermore, the dose in this study was a low dose, only minimally psychedelic, and people did not have to have a strong (or any) psychedelic experience when they took the drug to have a reduction in their migraine burden over the next couple weeks. This suggests that the acute effects of the drug while it’s in your body are not related to the improvement in migraine in the following weeks.”

The findings are in line with another study, published in 2015 by Schindler and her colleagues, which found that psilocybin mushrooms were being used to prevent and treat another type of painful headache disorder known as cluster headache, and were rated as more effective than conventional treatments. “Importantly, the doses used in cluster headache are typically on the low end and patients frequently express a dislike of taking higher doses,” Schindler noted.

Despite the promising findings, Schindler said that “there is a lot more research that needs to be done.”

“Different doses need to be studied and the effects and safety of repeating drug administration also need to be investigated,” she explained. “Ultimately, we still need to identify the doses and regimens that are safe and effective in managing migraine over the long-term. Migraine is a disease that stays with patients for decades, so we have to consider whether and how psilocybin might have a role in such a condition.”

“Migraine is also one of over a hundred distinct disorders that involve head and face pain, so what is learned here does not necessarily apply to these other disorders,” Schindler added. “It’s important to remember that there is no silver bullet when it comes to headache management. There are so many factors that contribute to migraine, including the brain, body, immune system, genetics, and environment, and there is no single treatment that will address all of them.”

“Psilocybin and related compounds might simply be added to the toolbox of treatment options. What we learned from this study though, is that psilocybin seems to work in a new way compared to other treatments, which is more valuable than simply replicating an already existing form of treatment.”

There were no serious adverse side effects reported by the participants. However, that doesn’t mean that psychedelic substances are completely safe. The participants underwent extensive physical and mental health screenings prior to the study, and they consumed psilocybin in a controlled setting.

“Psilocybin and other psychedelics are very powerful substances and can have significant physical and psychological consequences. Under certain conditions they can be safe, but this is not a group of compounds to be taken lightly,” Schindler said.

“We’re still learning how these drugs work and what they do to your body and mind, particularly over the long term. Researchers in the field are obsessed with safety because we know the great potential for these drugs to serve as medicines and don’t want to see their reputation tainted by unsafe practices (personal or commercial). Psychedelics are just re-emerging from decades of misunderstanding, fear, and stigma, and it won’t take much for them to fall prey to those influences again.”

*From the article here :

A single dose of psilocybin has a lasting therapeutic effect on migraine headache, according to a new placebo-controlled study

Scientists have started to investigate whether psilocybin, the primary substance responsible for the psychedelic effects of “magic” mushrooms, could be ...

www.psypost.org

 

[mr peabody]

How psychedelics impact headaches

by Uri Shine | PsyTech | 29 May 2022

The potential for psychedelics to treat mental health is no longer a secret held by counterculturalists and underground therapists. Research from top universities has established the benefits of psychedelics for depression, addiction, PTSD, end-of-life care, and much more. But in an interesting side note, recent research shows that psychedelics users are significantly more likely to have greater overall physical health.

What, if anything, can we read into this?

A connection to general health?

It’s important to remember that correlation does not establish causation. In this context, psychedelic users being more physically healthy does not necessarily suggest that psychedelics were the direct cause of the improvement. It could be that those who are more health-conscious would be more likely to stumble upon and try psychedelics. Similarly, recent research indicates that the insights people gain from psychedelics may lead them to adopt a healthier lifestyle.

The mind and body exist in a closed circuit. All illness is going to involve physical symptoms that manifest in our consciousness. Treatments at the physical level have effects at the psychological level, and vice versa.

Having said that, a growing number of studies point to the effectiveness of psychedelics in treating various physical ailments that people do not usually associate with the psychological, such as headaches.

Psychedelics treating inflammatory conditions

Inflammation is the body’s natural mechanism to protect us from harm. The process involves increased blood flow, proteins, and antibodies to the area of injury. Although the inflammatory response is critical to survival during injury, research has revealed that certain lifestyle factors including smoking, obesity, and chronic stress can lead to chronic inflammation (CI) which in turn can result in a wide array of serious diseases including cancer, cardiovascular disease, and autoimmune and neurodegenerative disorders.

For that reason, it is particularly exciting that researchers have discovered evidence that psychedelics have potent anti-inflammatory properties. In fact, certain drugs targeting 5HT2A receptors (as psychedelics do) seem effective in treating a wide range of inflammatory conditions in rats, including asthma and coronary artery disease.

In addition, researchers have completed phase 1 clinical trials on psychedelics to treat Alzheimer’s and other neurodegenerative diseases using LSD, thanks to its anti-inflammatory properties. The study demonstrated the safety and tolerability of 5-20 μg LSD in older healthy individuals.

Building upon these findings, researchers, in conjunction with the life sciences company Eleusis, are developing new drugs that act on the 5HT2A receptor to treat inflammatory conditions, yet which do not affect behavior. These findings stand to help treat a wide array of physical ailments associated with inflammation.

Psychedelics and Migraine Headaches

According to the Migraine Research Foundation, migraines are the third most prevalent and sixth most disabling illness in the world, affecting 12% of the population. Over 90% of sufferers are unable to work or function normally during a migraine. Researchers estimate the annual lost productivity costs of migraines in the U.S. at around $36 billion.

For years, anecdotal evidence has suggested that psychedelics can be effective in treating migraines. The first ever clinical trial to study psychedelics for migraines emerged earlier this year. Researchers from the Yale School of Medicine administered a low dose of psilocybin to 10 patients suffering from frequent migraines.

Those who took psilocybin experienced a significant reduction in the frequency of migraines over a 2-week period. Furthermore, psilocybin users had significantly reduced migraine-induced pain and functional impairments.

Psychedelics and Cluster Headaches

Cluster headaches (CH) can be some of the most painful experiences possible. Patients experience cluster periods, generally lasting between weeks and months, during which headaches usually occur every day or even multiple times a day. Each attack typically lasts between 15 minutes and 3 hours. Unsurprisingly, CH patients very often experience chronic depression, anxiety, and PTSD. The causes of CH remain largely unknown and there is no cure.

Like migraines, anecdotal evidence of the efficacy of psychedelics to treat CH drove initial research. In 2006, researchers published a study in which they surveyed 53 patients about their use of psychedelics to treat their CH. The results were overwhelmingly positive. 85% of patients found psilocybin effective in aborting attacks. 88% of patients found LCD effective in terminating their CH episode. Finally, LCD and psilocybin were very effective at extending patients’ remission periods (80% and 91% respectively).

No other preventative medication has achieved results as positive. Quoting a qualitative study, CH patients who use LSD “often experience full remission… and can potentially CURE cluster headaches!” Subsequently, Yale University is close to completing the first ever controlled clinical trial to validate these findings.

How do psychedelics treat Headache Disorders?

Both CH and migraine are headache disorders, or neurological conditions characterized by recurrent attacks. They do not seem to be rooted in the psychological realm. Yet psychedelics present great promise in providing effective treatment for these debilitating illnesses.

The causes of headache disorders are not wholly understood. Studies such as this one have identified multiple brain regions to be involved in producing and maintaining headache attacks. It is therefore unsurprising that the mechanism of action of psychedelics to treat headache disorders is not totally clear either. However, in a lecture on headache disorders given at the recent PsyTech summit, Dr. Emmanuelle Schindler from the Yale School of Medicine suggested the following as areas worth exploring: hypothalamic and hormonal function, inflammatory systems, and circadian rhythms.

Importantly, we need further research to confirm these initial findings – research with larger and more representative sample sizes, longer durations of observation, and more experimentation with different dosages and frequencies of use.

To conclude

There is a plenitude of areas of disease that are worth mentioning here yet as of yet, many lack clinical or animal trials. These include autoimmune conditions, brain injury, and phantom limb pain, among others.

A great deal more research is needed to fully understand the magic of how psychedelics treat both the symptoms and causes of such a wide array of diseases. But what does seem clear is that the benefits of psychedelics for mental health are likely to be just the tip of the iceberg.

How Psychedelics Impact Headaches - PsyTech

Psychedelics' impact on mental health is well documented. Emerging research is proving their benefits to chronic headaches too.

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