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mr peabody

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Chronic sufferers choosing psilocybin for migraines

by Michael Chary | GAIA | 7 Mar 2020

I remember the day I got my first migraine pretty vividly. I was a freshman in high school sitting in math class, when all of a sudden, my vision became blurry. I soon felt shaky, nauseous, incredibly confused, and frightened by what was happening to me. But in the hour or two it took to see a doctor, my symptoms had disappeared.

Eventually, I realized I had experienced my first migraine, and since then I suffer through a few every year. While they're pretty debilitating and can ruin an entire day, I'm lucky I don't suffer from chronic migraines like some do.

In the U.S. it's estimated that roughly 3.2 million Americans live with chronic migraines and of that percentage, some experience 15 to 20 a month. These headaches last four hours or more on average, and often force sufferers to take days off work. This adds up to not only lost hours of their lives, but lost productivity and money. In fact, it's estimated up to $31 billion in productivity is lost annually from headache disabilities in the U.S. alone.

I can tell when a migraine is coming on because of a chain of predictable symptoms. First, I begin to see auras and my vision is blurred, then all symptoms subside like the calm before a storm, and finally the piercing headache, nausea, vomiting, and shakiness.

Hallucinations and bizarre visuals often accompany or signal to migraine sufferers they're about to endure a headache. The most common visual oddities are blurriness and auras, but some experience zigzags, swirling vortices, and Picasso-esque patterns. Physical hallucinations arent unusual either.

During his first migraine, author, Anthony Peake, says, "I felt that the top of my head was lifting off and moving upwards toward the ceiling. Then I noticed the office seemed to be getting smaller, as if I was looking at it from the wrong end of a telescope."

Only about 15 to 20 percent of migraine sufferers experience migraines with auras. These migraines can be so disorienting and confusing, sometimes rendering sufferers unable to communicate properly, almost like a stroke. But despite the well-documented symptoms and prevalence of these painful experiences, doctors still don't know what causes them exactly.

Headache disorders are ranked 7th in all disabilities globally, though only 36 percent of sufferers are diagnosed. And migraines aren't even the worst type of debilitating headache - that title is reserved for cluster headaches.

Cluster headaches have been described as one of the worst pains a human being can feel, worse than childbirth, or as one sufferer put it, worse than having a limb amputated without anesthesia. Cluster headaches have been nicknamed the suicide headache for reasons that can probably be inferred.

These two types of headaches tend to occur in one gender more than the other, with migraines choosing women, and cluster headaches more often reserved for men. Some attribute this to hormonal functions, but no one really knows for certain.

Specific things activate migraines, including caffeine, lack of sleep, alcohol, weather fluctuations, and stress. Cluster headaches, on the other hand, seem to fall into episodic cycles, and contrary to migraines, sleeping can actually trigger them. Sufferers often get cluster headaches as they're entering REM sleep, leading them to fear bedtime.

LSD and psilocybin for migraines

Sometime in 2015, well over a decade after my headaches began, I was at a friend's house when I felt the early signs of an oncoming migraine. I alerted my buddies to what would happen and the protocol I typically followed to deal with the next few hours of pain.

My friend Sean said he wanted to make me something that might help my symptoms. So he whipped out his mortar and pestle and began making me a chunky paste, while I laid on the couch, preparing for the impending agony. After a few minutes, he came back with the paste and a glass of water, telling me to consume the strange concoction.

I asked what was in it and he replied, "Some honey, various herbs, and some (magic) mushrooms. Not enough to make you trip, just a micro-dose, but there's a chance you might feel a body high. It will definitely help your symptoms, though."

Now, full disclosure, I had taken psilocybin before, so I was familiar with its effects, but the idea of a potential psychedelic trip while suffering from a mind-numbing headache sounded like a horrible idea. But I trusted Sean and took the mushroom mixture.

For chronic headache sufferers, there are a number of pharmaceuticals prescribed to mitigate their symptoms and lead a semi-normal life. Triptans are one of the most commonly prescribed, often paired with an NSAID, i.e. aspirin or ibuprofen. But these drugs are not a panacea and only provide temporary relief.

Triptans are referred to as selective serotonin receptor agonists, stimulating serotonin production in the brain. This serotonin increase reduces inflammation and constricts blood vessels to alleviate the headache. Triptans belong to the tryptamine family of monoamine alkaloids. Coincidentally, the psychoactive compounds found in many psychedelics are also tryptamines.

Psilocybin converts to psilocin in the body, becoming a partial agonist for serotonin receptors known as 5-HT receptors, particularly the 5-HT(2b) and 5-HT(2a) receptors. Psilocybin and other tryptamines, including DMT and LSD, are referred to as serotonergic psychedelics because they activate these serotonin receptors. Triptans work as agonists on serotonin receptors in the same way, but instead stimulate 5-HT(1b) and 5-HT(1d) receptors.

For reasons not fully understood, the receptors that psilocybin and LSD target produce a psychedelic experience, while the receptors the triptans target do not. However, when both receptors are targeted, the psychedelic experience can be amplified immensely, but not in a pleasant way.

Unsurprisingly, another pharmaceutical used in the past to treat migraines, due to its affinity for those 5-HT receptors, is ergotamine, a peptide derived from ergot fungus, first isolated by Arthur Stoll at Sandoz Pharmaceuticals in 1918. Stoll worked alongside Albert Hoffman, the famous chemist who first synthesized LSD at Sandoz from, you guessed it, ergotamine.

When Hoffman accidentally synthesized LSD he had also worked to isolate psilocybin from the mushroom Psilocybe mexicana. Sandoz sold psilocybin to clinicians using it for psychotherapy, before the drug was criminalized in 1968. It's believed that Hoffman was actually working on synthesizing new medicines to treat headaches, which he may have apparently found, though the hype from his discovery's psychedelic properties completely overshadowed any other use for it.

After Sean gave me the micro-dose of magic mushrooms, my headache began to play out as expected. My liver had to first process the psilocybin, convert it to psilocin, and release a number of metabolites into my bloodstream; a process that usually takes 30 to 45 minutes. But after that time had passed, it felt like I had skipped the worst part of my headache and was coasting through the dull afterglow that marks the latter stage of my migraines. I also felt a little woozy, the feeling I knew the mushrooms were responsible for.

It seemed Sean's magic mushroom remedy worked. It didn't stop the headache dead in its tracks, but it did mitigate the pain significantly and shorten the span of it. Now, had I been working at the time, the subtle psychoactive effects of the psilocybin may have been distracting, but with a full-blown migraine, no work would have been accomplished anyway.

Cluster Busters - Using psychedelics for headaches

Triptans, steroids, and other pharmaceuticals prescribed to treat chronic bouts can have long-term side effects ranging from organ fibrosis, cardiac disturbances, and even osteoporosis. And while triptans are good for alleviating individual headaches, chronic sufferers have found that psychedelic serotonergics can break or even prevent the episodic cycles of headaches that recur on a predictable basis.

Those unfortunate enough to suffer from cluster headaches experience as many as eight to 10 a day during cycles. Though they don't suffer year-round, cycles typically last anywhere from two to three-months, with each headache lasting anywhere from 45 minutes to three hours.

Bob Wold is the founder and president of Cluster Busters, a group that has, for the past 15 years, advocated for the study and legal use of psilocybin and LSD for treatment of cluster headaches. Wold began suffering from them biannually for a period of 20 years after being misdiagnosed many times. He was ineffectually prescribed 75 different medications, including the highly addictive fentanyl and even cocaine drops.

Wold was so desperate to ease the pain that he almost underwent an invasive, unproven surgery that would have severed his trigeminal nerves and destroyed all sensation in his face. That was, until he found an online forum touting the benefits of serotonergic psychedelics for treating his condition.

Wold said he asked his two kids, who happened to be in college, to procure him the necessary psilocybin-containing mushrooms to see if they could ameliorate his agonizing pain. While he doesn't condone buying psilocybin mushrooms off the street, as acquiring them is illegal and hard to determine exact dosage, Wold was in a desperate state and willing to take risks.

Shortly after using the drug to treat his headaches, Wold noticed an immediate difference, saying his head hadn't felt that good in the 20 years since his condition began. From then on, he used the drug as both an analgesic and a preventative measure, spreading the word to fellow sufferers as often as possible.

Cluster Busters says it believes the key difference between triptans and serotonergic psychedelics is that the receptor targeted by the latter acts as a vasoconstrictor, preventing attacks by keeping the carotid artery from expanding and pressing on the trigeminal nerves.

Unfortunately, taboos and legal constrictions have made it hard to gauge doses and procure these drugs safely for chronic headache sufferers, but recent persistence and overwhelming anecdotal evidence from Cluster Busters has led to legally approved trials of the drugs for treatment of severe chronic headaches.

Researchers like Harvard psychiatrist, Dr. John Halpern, decided to look more closely into the stories being reported from Cluster Busters and conduct a study of his own. After interviewing 53 subjects who used a serotonergic psychedelic to treat cluster headaches, he found that 95 percent successfully delayed or completely avoided headaches. This led Halpern to set up future double-blind studies with control groups to properly test results.

Much like the dose I received from Sean to treat my migraine, the doses used by most cluster headache sufferers are micro-doses, or non-psychedelic doses. Even the slightly larger, preventative doses Wold takes a few times a year , he says, are roughly tantamount to a buzz from a few glasses of wine - enough to make lights look slightly more vivid.

Another strong proponent who deserves mention for use of psychedelics to treat chronic headaches is Graham Hancock. Hancock says at one point he was suffering from up to 20 severe migraines a month, before he took Ayahuasca and Iboga in shamanic ceremonies.

Ayauhasca is an Amazonian brew containing DMT, another serotonergic psychedelic found in many plants. Today, after suffering from chronic headaches his entire life, Hancock no longer suffers from them at all, and has vowed to take Ayahuasca two to three times a year to prevent them, and for the spiritual experience it provides.

Of course, one should tread with caution when considering these drugs for treatment. Wold says it's important to consult a doctor to ensure these psychoactive substances won't react adversely with any other medications one might be on, and to assure that one is healthy enough to take them.

With any luck, further research into serotonergic psychedelics can help relieve the pain for victims of chronic headaches and eliminate the unwarranted stigma placed on a natural substance with medicinal value. For more information visit the Cluster Busters website or MAPS, another group that continues to achieve funding and legal permission to advance clinical trials studying the healing potential of psychotropic drugs.

https://www.gaia.com/lp/content/psyc...for-migraines/
 
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Thomas Jefferson University Hospital

Ketamine may help treat migraine pain unresponsive to other therapies

American Society of Anesthesiologists | Oct 21, 2017

Ketamine, a medication commonly used for pain relief and depression, may alleviate migraine pain in patients who have not been helped by other treatments, suggests a study being presented at the ANESTHESIOLOGY 2017 annual meeting.

The study of 61 patients found that almost 75 percent experienced an improvement in their migraine intensity after a 3 to 7 day course of inpatient treatment with ketamine. The drug is used to induce general anesthesia but also provides powerful pain control for patients with many painful conditions in lower doses than its anesthetic use.

"Ketamine may hold promise as a treatment for migraine headaches in patients for whom other treatments have failed," said study co-author Eric Schwenk, M.D., director of orthopedic anesthesia at Thomas Jefferson University Hospital in Philadelphia. "Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term. Our work provides the basis for future, prospective studies that involve larger numbers of patients."

An estimated 12 percent of the U.S. population suffers from migraines, recurring attacks of throbbing or pulsing moderate to severe pain. A subset of these patients, along with those who suffer from other types of headaches, do not respond to treatment. People with migraines are often very sensitive to light, sound and may become nauseated or vomit. Migraines are three times more common in women than in men.

Researchers reviewed data for patients who received ketamine infusions for intractable migraine headaches, migraines that have failed all other therapies. On a scale of 0-10, the average migraine headache pain rating at admission was 7.5, compared with 3.4 on discharge. The average length of infusion was 5.1 days, and the day of lowest pain ratings was day 4. Adverse effects were generally mild.

Dr. Schwenk said while his hospital uses ketamine to treat migraines, the treatment is not widely available. Thomas Jefferson University Hospital will open a new infusion center this fall that will treat more patients with headaches using ketamine. "We hope to expand its use to both more patients and more conditions in the future," he said.

"Due to the retrospective nature of the study, we cannot definitively say that ketamine is entirely responsible for the pain relief, but we have provided a basis for additional larger studies to be undertaken," Dr. Schwenk added.

https://www.asahq.org/about-asa/news...ther-therapies
 
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LSD and psilocybin may alleviate cluster headaches

by Abigail Calder, MSc | Psychedelic Science Review | 14 Jul 2020

Three clinical trials are underway to find out if these psychedelic compounds can provide relief for patients.

As research on psychedelics expands, so does the list of conditions they might treat. One perhaps surprising addition to that list is cluster headache disorder, which affects up to 1 million people in the United States alone. Sufferers have been discussing psychedelic treatments amongst themselves for years, and clinical research is finally catching up with them.

This is potentially life-changing news for cluster headache patients, many of whom have not yet found a treatment that alleviates their pain. And pain is an understatement. Cluster headaches have earned themselves the grim nickname of “suicide headaches,” rating a solid 10 out of 10 on the pain scale. And, as the name suggests, the headaches come in groups. Patients can have several headache attacks per day for weeks or months, preventing them from living normal lives and even causing PTSD. For those who haven’t found an effective treatment, any possibility for relief may be worth trying.

How could psychedelics help cluster headaches?

It was indeed the patients themselves who sparked scientific interest in treating cluster headaches with psychedelics. In the early 2000s, one patient contacted Dr. John Halpern, a psychiatrist at Harvard Medical School. He had an interesting story to tell. After being plagued with cluster headaches for 18 years, his recreational use of LSD and psilocybin had the unexpected side effect of curing his headaches. Dr. Halpern and his team were intrigued and suspected this patient might not be an isolated case. Through online forums and support groups, they located 53 other people who had attempted to treat cluster headaches with psychedelics. For the majority of them, it alleviated their symptoms.

Other researchers have expanded on this work in both medical case reports and survey studies. According to an extensive analysis of patient discussion forums, psilocybin and LSD appear to be the most widely praised psychedelic treatments. People have also had success with other compounds, including the mostly-legal Hawaiian Baby Woodrose plant. However, most patients who use psychedelics to relieve their cluster headaches are desperate enough to accept the risk of possessing a controlled substance. Doctors in Spain reported on one such patient who had turned to psilocybin after nothing else worked. Intriguingly, the patient did not need a large dose to achieve freedom from his headaches: one monthly microdose was enough to keep him symptom-free for at least six months.

Dr. Halpern’s original study also supports the idea that large doses may not be necessary. For many of his 53 patients, sub-hallucinogenic doses were effective in alleviating symptoms. Even more remarkably, patients reported that psychedelics could terminate an ongoing cluster attack within 20 minutes – a property most pharmacological treatments lack. And as is seen with psychedelics in other clinical settings, a little bit goes a long way. Prescription medicines designed to prevent cluster headaches generally need to be taken every day, whereas a single dose of LSD or psilocybin could be effective for weeks.

How can this be? One theory dominates the scientific literature, although it hasn’t been scientifically proven. Like the current standard treatments for cluster headaches – drugs called triptans – psilocybin and LSD interact with serotonin receptors in the brain. Although psychedelics have a slightly different mechanism of action than triptans do, they both constrict the blood vessels through their action at serotonin receptors. Constricting blood vessels might end the headache because enlarged blood vessels cause pressure to build up in the brain. This pressure, in turn, causes inflammation and pain. This may be the source of cluster headaches, although no one knows why the blood vessels become enlarged in the first place.

Triptan treatments don’t work for everyone, and as Dr. Halpern notes in his study, neither do psychedelics. But some people who don’t respond to standard treatments achieve freedom from headaches with psilocybin and LSD, and they may not need to be taken frequently to be effective. Even though it was only a survey study, Dr. Halpern and his co-authors found the evidence in their hands difficult to dismiss. Over a decade later, other scientists are thinking the same thing.

Clinical trials are under way

As of May 2020, three clinical trials of psychedelics for treating cluster headache are running worldwide. The Heffter Research Institute is currently sponsoring a psilocybin trial at Yale, using low and high doses. A similar study is running at one of the largest hospitals in Denmark. And the University of Basel in Switzerland, one of the most prolific sources of research on LSD these days, is testing hallucinogenic doses of LSD in their Phase 2 trial.

Drug approval processes are painfully slow, but the good news is that the clinical trial machinery is now in motion. If psychedelics really can help people whose lives are controlled by cluster headaches, it’s only a matter of time before these treatments become safely available to those who need them.

 
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Phase 2 clinical trial of LSD for 'suicide headaches' begins treating patients

Mind Medicine | PR Newswire | 8 Jun 2020

MindMed Is collaborating on a phase 2 clinical trial of LSD for cluster headaches with University Hospital Basel's Liechti Lab.

Mind Medicine Inc. is supporting and collaborating on a Phase 2 clinical trial evaluating LSD for the treatment of cluster headaches at University Hospital Basel's Liechti Lab. The Phase 2 trial began recruiting patients in early January and has commenced treating patients with LSD.

MindMed is the leading neuro-pharmaceutical company for psychedelic inspired medicines and previously formed an ongoing R&D collaboration with the University Hospital Basel's Liechti Lab, the leading global clinical research laboratory for LSD, to evaluate multiple therapeutic uses of psychedelics and next-gen psychedelic therapies. This new development is part of the collaboration and Dr Matthias Liechti is serving as principal investigator of the clinical trial.

Cluster headaches, also known as 'suicide headaches,' due to the severity of the pain caused are often viewed as one of the most profoundly painful conditions known to mankind. The pain occurs on one side of the head or above an eye and can last for weeks or months. Studies have demonstrated increased suicidality associated with patients experiencing cluster headache attacks.

Non-clinical and anecdotal evidence suggests LSD can abort attacks and decrease the frequency and intensity of the attacks. There is a need for new treatment approaches for cluster headaches as current available medications often mismanage cluster attack periods.

The Phase 2 trial is investigating the effects of an oral LSD pulse regimen (3 x 100 µg LSD in three weeks) in 30 patients suffering from Cluster Headaches compared with placebo. The study is a Double-blind, randomized, placebo-controlled two-phase cross-over study design.

MindMed Co-founder & Co-CEO JR Rahn said "As we continue on our mission to discover, develop and deploy psychedelic inspired medicines, we are very encouraged to bring this potential treatment for cluster headaches using LSD out of the shadows and evaluate its efficacy based on clinical research standards with the Liechti Lab."

MindMed's collaboration will assess if there is clinical evidence for a future commercial drug trial through the FDA pathway at a later date. Treatments for cluster headaches may potentially qualify for an Orphan Drug Designation and be eligible for certain development incentives provided by the FDA for rare diseases.

Liechti Lab and MindMed intend to learn how they can make the administration of LSD more targeted for cluster headache patients through this Phase 2 trial and future clinical trials. As part of the collaboration with UHB Liechti Lab, MindMed gains exclusive, global use to all data and IP generated in the Phase 2 trial of LSD for cluster headaches.

 
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A study by University of Arizona Health Sciences researchers found that green light therapy
resulted in about a 60% reduction in the pain intensity of the headache phase.


Green light therapy shown to reduce migraine frequency, intensity

by University of Arizona | Medical Xpress | 10 Sep 2020

New research from the University of Arizona Health Sciences found that people who suffer from migraine may benefit from green light therapy, which was shown to reduce the frequency and intensity of headaches and improve patient quality of life.

According to the Migraine Research Foundation, migraine is the third most prevalent illness in the world, affecting 39 million people in the United States and 1 billion worldwide.

"This is the first clinical study to evaluate green light exposure as a potential preventive therapy for patients with migraine," said Mohab Ibrahim, MD, Ph.D., lead author of the study, an associate professor in the UArizona College of Medicine—Tucson's Department of Anesthesiology, Pharmacology, and Neurosurgery and director of the Chronic Pain Management Clinic. "As a physician, this is really exciting. Now I have another tool in my toolbox to treat one of the most difficult neurological conditions—migraine."

Overall, green light exposure reduced the number of headache days per month by an average of about 60%. A majority of study participants—86% of episodic migraine patients and 63% of chronic migraine patients—reported a more than 50% reduction in headache days per month. Episodic migraine is characterized by up to 14 headache days per month, while chronic migraine is 15 or more headache days per month.

"The overall average benefit was statistically significant. Most of the people were extremely happy," Dr. Ibrahim said of the participants, who were given light strips and instructions to follow while completing the study at home. "One of the ways we measured participant satisfaction was, when we enrolled people, we told them they would have to return the light at the end of the study. But when it came to the end of the study, we offered them the option to keep the light, and 28 out of the 29 decided to keep the light."

Dr. Ibrahim and co-author Amol Patwardhan, MD, Ph.D., who are affiliated with the UArizona Health Sciences Comprehensive Pain and Addiction Center, have been studying the effects of green light exposure for several years. This initial clinical study included 29 people, all of whom experience episodic or chronic migraine and failed multiple traditional therapies, such as oral medications and Botox injections.

"Despite recent advances, the treatment of migraine headaches is still a challenge," said Dr. Patwardhan, an associate professor and the vice chair of research in the Department of Anesthesiology. "The use of a nonpharmacological therapy such as green light can be of tremendous help to a variety of patients that either do not want to be on medications or do not respond to them. The beauty of this approach is the lack of associated side effects. If at all, it appears to improve sleep and other quality of life measures."

During the study, patients were exposed to white light for one to two hours a day for 10 weeks. After a two-week break, they were exposed to green light for 10 weeks. They completed regular surveys and questionnaires to track the number of headaches they experienced and the intensity of those headaches, as well as quality of life measurements such as the ability to fall and stay asleep or to perform work.

Using a numeric pain scale of 0 to 10, participants noted that green light exposure resulted in a 60% reduction in pain, from 8 to 3.2. Green light therapy also shortened the duration of headaches, and it improved participants' ability to fall and stay asleep, perform chores, exercise, and work.

None of the study participants reported any side effects of green light exposure.

"In this trial, we treated green light as a drug," Dr. Ibrahim said. "It's not any green light. It has to be the right intensity, the right frequency, the right exposure time and the right exposure methods. Just like with medications, there is a sweet spot with light."

Dr. Ibrahim has been contacted by physicians from as far away as Europe, Africa and Asia, all asking for the green light parameters and schematic design for their own patients.

"As you can imagine, LED light is cheap," he said. "Especially in places where resources are not that available and people have to think twice before they spend their money, when you offer something affordable, it's a good option to try."

The paper, "Evaluation of green light exposure on headache frequency and quality of life in migraine patients: A preliminary one-way cross-over clinical trial," was published online by Cephalalgia, the journal of the International Headache Society.

"These are great findings, but this is where the story begins," Dr. Ibrahim said. "As a scientist, I am really interested in how this works because if I understand the mechanism, then I can utilize it for other conditions. I can use it as a tool to manipulate the biological systems to achieve as much as we can."

 
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This shows a psychedelic brain

Results from a small trial reveal psilocybin may have a therapeutic effect for migraine sufferers.

Psilocybin shows potential as a treatment for migraine headaches

Yale University | Neuroscience News | 23 Nov 2020

A new small scale study reveals psilocybin has a beneficial effect for chronic migraine sufferers.

A small-scale study conducted by researchers at Yale University reveals psilocybin, a naturally occurring psychedelic compound in “magic mushrooms,” appears to be effective in the treatment of migraine disorders.

Previous studies have shown psilocybin to show promise in the treatment of migraines and cluster headaches, but most of the results have been anecdotal. This is the first study to compare the effects of psilocybin and a placebo for the treatment of chronic migraine.

Ten participants were involved in this study. All subjects were required to monitor their headaches for two weeks and complete a “migraine diary” prior to the start of the study. During the double blind study, participants were given either a placebo or low dose of psilocybin during two sessions, two weeks apart.

Compared the the participants in the placebo group, those administered psilocybin treatments reported a significant decrease in migraine days one week after the first session.

Researchers reported none of the participants experienced adverse effects or problems with withdrawal following psilocybin treatments, and the drug was well tolerated.

While researchers say more studies are required to fully assess the potential of psilocybin as a treatment for migraine, they report there appears to be a beneficial therapeutic effect of the drug after a single exposure.

 
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A single low dose of psilocybin reduces the frequency of migraine headaches for 2 weeks

Psilocybin Alpha | 14 Nov 2020

The study, published Thursday 12th November, sought to add empirical rigour to anecdotal evidence suggesting that a low dose of psilocybin (and other 5-HT2A agonists) may have an enduring positive effect on headache disorders.

To this end, the research team undertook a double-blind, placebo-controlled cross-over study in which 10 adult migraine sufferers received either psilocybin or placebo.

The psilocybin dose in this study is low, at 0.143mg/kg. As such, an adult weighing 75kg would receive around 10 mg of psilocybin.

Doses for psilocybin-assisted therapy, in contrast, are much larger. In their seminal study of dose-related effects, Griffiths et al. (2011) evaluated psilocybin administered in doses up to 30mg (per 70kg). When studying psilocybin-assisted therapy for treatment-resistant depression, Carhart-Harris et al. (2016) administered two doses seven days apart, with the larger dose being 25mg.

The low dose of psilocybin was delivered in 2 sessions, with a 2-week interval between. Participants recorded the incidence of migraines in headache diaries, with entries beginning 2 weeks prior to the first session, and ending 2 weeks following the second session.

Ultimately, the study found that the reduction in the frequency of migraine days after receiving psilocybin was significantly larger than placebo.

The study reports that psilocybin was well-tolerated by all participants, and that the effect size was not correlated with the intensity of psychotropic effects during psilocybin adminsitration.

It’s important to note that this was a small (n=10), exploratory study. Yet, its results are promising and pave the way for further research.

This new research contributes to a growing body of evidence suggesting that the acute psychotropic effects of 5-HT2A agonists, namely psilocybin, are not the sole vehicle for therapeutic benefit. Rather, it appears that psilocybin can have an enduring therapeutic benefit that is distinct from its psychedelic effect, demonstrating significant scope for further research.

 
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Psilocybin Mushroom Migraine



Suffer from migraines? Psilocybin can reduce their frequency*

by Mike Hitch | 24 Nov 2020

A first-of-its-kind exploratory study has found that a single dose of psilocybin mushrooms (magic mushrooms) can reduce migraine frequency by 50 per cent for at least two weeks.

In case you needed any more reason to celebrate psilocybin, a recent study, led by researchers from the Yale School of Medicine, has shone a light on more potential benefits of the magic mushroom compound – this time in relation to migraines.

The double-blind placebo-controlled cross-over study yielded promising results for the effects of psilocybin on migraine frequency.

While data up until recently has been anecdotal at-best, this new study involved a small trial of ten migraine sufferers, where some participants were given a placebo and others were given psilocybin over a total of two sessions. The participants were first asked to spend two weeks keeping a ‘headache diary,’ a practice that was maintained leading up to and following each session.

The author of the new study, Dr Emmanuelle Schindler, confirmed that psilocybin did have a profound impact in reducing the severity and frequency of migraines.

“Compared to placebo, a single administration of psilocybin reduced migraine frequency by about half over the two weeks measured,” he said 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 per cent each.”

Most interestingly, the results, published in the journal Neurotherapeutics, showed a lack of correlation between the strength of the psychedelic experience and the therapeutic effect.

Unlike psilocybin treatments for depression and addiction, which suggest that the intensity of the psychedelic experience impacts its therapeutic benefits, the migraine/psilocybin trial did not detect that association.

In fact, subjects who reported the high levels of altered consciousness showed smaller reductions in migraine frequency.

This means that the therapeutic effects of psilocybin can perhaps be achieved through microdosing, a practice where sub-hallucinogenic doses of psychedelic substances are taken to improve creativity, mood, and general outlook.

“This is definitely a finding we’re interested in exploring further,” Dr Schindler said.

“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.”

While the results are exciting, Dr Schindler warns that this was a small preliminary study, aimed at hopefully uncovering potential areas worth deeper investigation. Well, looks like she may have found some.

Not only do these new finding offer insight into how psychedelic compounds could help those suffering from debilitating migraines, but the study also sheds a fraction of light onto the unexplained physiological causes of chronic headache disorders.

Most interestingly, the results, published in the journal Neurotherapeutics, showed a lack of correlation between the strength of the psychedelic experience and the therapeutic effect.

Unlike psilocybin treatments for depression and addiction, which suggest that the intensity of the psychedelic experience impacts its therapeutic benefits, the migraine/psilocybin trial did not detect that association.

In fact, subjects who reported the high levels of altered consciousness showed smaller reductions in migraine frequency.

This means that the therapeutic effects of psilocybin can perhaps be achieved through microdosing, a practice where sub-hallucinogenic doses of psychedelic substances are taken to improve creativity, mood, and general outlook.

“This is definitely a finding we’re interested in exploring further,” Dr Schindler said.

“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.”

While the results are exciting, Dr Schindler warns that this was a small preliminary study, aimed at hopefully uncovering potential areas worth deeper investigation. Well, looks like she may have found some.

Not only do these new finding offer insight into how psychedelic compounds could help those suffering from debilitating migraines, but the study also sheds a fraction of light onto the unexplained physiological causes of chronic headache disorders.

Dr Schindler’s next migraine study is starting soon and will focus on longer follow-up periods and different dose effects. However, she also plans to investigate the effects of psilocybin on post-concussion headaches, which are similar to a migraine.

“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,” she said.

*From the article here:
 
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Exploratory study indicates psilocybin provides relief for migraines

by Alex Criddle, MA | Psychedelic Science Review | 22 Dec 2020

Interestingly, changes in migraine frequency were not correlated with the intensity of the acute psychotropic effects.

Migraines are the third most common illness in the world, with 12% of the population suffering from them. Only 25% of people with migraines benefit from any sort of preventive treatment and only 12% of those people actually receive it.

While there are a number of treatments for migraines, they have very limited efficacy on most people and fail to provide long-term relief. This has led to an increased interest in the potential of psychedelics, particularly 5-HT2A receptor antagonists such as LSD and psilocybin, as possible remedies for migraines.

Anecdotal data of people using psychedelics for relief has existed for a number of years. In these reports, psilocybin and LSD provided the best results,1 but psilocybin’s effects on migraines were just recently explored in a clinical trial by Schlinder et al.2 These researchers wanted to do an exploratory double-blind, placebo-controlled, cross-over study as a proof-of-concept investigation that will lead to further studies.

Study design

Twelve of 69 screened individuals participated in the study. One of them did not complete the second part and another’s baseline period did not include enough migraines for qualification. Thus, the final analysis included ten subjects. Each subject was given an oral placebo in one session and a psilocybin dose of 0.143 mg/kg in another test session with two weeks between sessions.

This study was double-blinded. That means neither the recipients nor the administrator knew if they were given the placebo or the psilocybin. The subjects maintained headache diaries starting two weeks before the first session and continued through two weeks after the second session. The subjects were monitored physiologically and psychologically during the sessions. They were contacted multiple times during the study to ensure their safety and health.

Study findings

Eight of the subjects had a 25% reduction in migraine days over the two week period after the psilocybin was administered. Five subjects showed a 50% reduction and three subjects showed a 75% reduction. After given the placebo, only two subjects showed a 25% reduction and two showed a 50% reduction in migraine days. The others showed no change. Overall, the psilocybin provided a significant decrease in the weekly migraine attacks and in the pain severity and migraine attack-related functional impairment. This was not the case for the placebo.

Given that psilocybin is known to acutely cause headaches, the researchers measured the times to both the first and second migraine attacks. The first attack was essentially the same. However, there was a significant increase in the time between attacks after receiving psilocybin than after receiving the placebo.

Overall, the psilocybin dose was well-tolerated by the subjects. There were no unexpected or serious adverse events or withdrawals due to the events. This suggests that psilocybin is a relatively safe treatment option for those with migraines. Interestingly, the data revealed The researchers found that the change in migraine frequency was not correlated with the intensity of the psychotropic effects of the drug.

Study limitations and conclusions

This study had several limitations. The sample size was quite small and homogenous. All of the subjects were caucasian and had a high number of migraine-related attacks. The data from this trial only consists of a short period of time after the trial was completed. This leaves the long-term effects of psilocybin on migraines a mystery.

The Schindler et al. study provides data for the safety and proof-of-concept effects of psilocybin on migraines, for which anecdotal data has existed for a few decades. Psilocybin appears to be a relatively safe avenue for much-needed relief for individuals who have migraines. The data also revealed that the intensity of the participants’ psilocybin experience was not related to how often they got migraines. This finding sets a new research path for researchers all on its own.

 
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Tuning in to psychedelics for treatment of suicide headaches*

by Peter McAllister, MD

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

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 psychedelics, although often in sub-psychedelic 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.

LSD and psilocybin

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 PTSD throughout the 1950s and 1960s.8 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.

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 non-psychedelic 2-bromo-LSD [bol-148]) are anecdotally reported to have efficacy for treating people with CH.13 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 study

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 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 non-psychedlic 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 mushrooms.

*From the article here :
 
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Psilocybin & migraine: First of its kind trial reports promising results

by Rich Haridy | NEW ATLAS | 22 Nov 2020

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 new study was published in the journal Neurotherapeutics.

 

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Okay..., the expensive pharmaceutical..., or the cheap, effective option?

by Dennis Powell | The Athens NEWS | 12 Feb 2020

Here’s some good news, really good news, and this is no joke.

If you have never suffered from migraine or cluster headaches, drop to your knees each day in thanks. Lots of people have suffered and continue to suffer from these debilitating, agonizing conditions. For a long time there was no effective treatment.

Migraine and cluster headaches are related, but they’re not the same. A migraine is a powerful headache generally preceded by some kind of visual disturbance, often a blind spot filled with garish, flashes like the spiky lights atop a carnival ride at night. It can last for days. Cluster headaches come in clusters, as the name implies. They typically arrive at the same time each day and last for several hours. Often their arrival is a couple of hours after the sufferer has gone to sleep.

Both can be unspeakably painful, with cluster headaches much more severe. Think of the headache you would get from chugging a frozen margarita. Now think of that lasting for hours. The pain is so severe that it has driven some people to suicide.

When you have a cluster headache or migraine, it owns you.

Both kinds of headaches involve pressure on the trigeminal nerve, though the mechanism is not well understood. And until fairly recently there was no effective treatment. A few decades ago a pharmaceutical compound, Sumatriptan, was approved for treatment of migraine and cluster headaches, and in my experience it is very effective. It comes in injectable form as well as pills and nasal spray. I chose the spray, which works in about 15 minutes. The other methods take longer.

I keep some around for emergencies – and believe me, when you get whacked by a migraine or worse, a cluster headache, it’s a personal emergency. But the stuff is expensive: last time I filled a prescription it was $54 per squirt. Worth every penny, but still.

Sumatriptan, sold under the brand name Imitrex, is not a worry-free solution, though. No one is sure why it works. And the side effects can be severe – as in: they can kill you. (This is rare; it has never killed me, and I’ve used it from time to time for two decades.)

Now. What I’m about to describe involves a research sample size of - just me. But other research confirms what I found in my own little experiment 10 days ago.

The evening of Groundhog Day I experienced a visual disturbance which told me that soon I’d be owned by a full-blown migraine. My Sumatriptan supply, though plentiful, had expired. I didn’t think that this would be a problem. I went online to confirm this, reading with my peripheral vision. (I should note that there are some additional, more subtle symptoms, among them worry: What if this time the medicine doesn’t work? What if the visual display never goes away? What if this time it’s a stroke or something?)

While I was looking sideways at web pages, I happened on a study that surprised the hell out of me. In a double-blind experiment, migraine sufferers reported that plain old ginger – yes, the stuff you get to make gingerbread – was just as effective as Sumatriptan.

As it happens, I had some ginger, in the form of “gold kili Instant Honey Ginger Drink,” which I get in a bag of 20 individual packets for $3.99 at the Oriental Market on East State Street. My friend Marjorie introduced me to it years ago; she found it tasty and soothing as a hot drink on cold nights, especially when one has a cold.

So, with migraine pain en route, I decided it was time for a little experiment. I made a nice, warm cup of the stuff and eagerly consumed it. The pain arrived, but then… went away! It was all gone, as with Imitrex, in about 15 minutes. Which is to say the 20-cent packet of ginger drink was in my case as effective as a $54 dose of Sumatriptan. Your results, as the television ad lawyers tell us, may vary.

(I have not tried it on cluster headaches, and I hope you’ll forgive my not wishing for the opportunity to do so, but the mechanisms are believed to be much the same, so there’s some likelihood that it will stop, or at least mitigate, those, too.)

There’s more. Sumatriptan, as I mentioned, has serious potential side effects. With few exceptions – those who may not consume ginger for one medical reason or another, even as some people may not safely consume grapefruit – ginger has no side effects much beyond some people not liking it.

I have to say that I was skeptical, until the ginger worked. Over the years I’ve gotten exposed to a lot of flaky treatments and cures to a lot of real and imagined conditions, offered by the attractive but flaky sorts of persons who used to appear in old “Herbal Essence” shampoo commercials. I’ve spoken with many people who offered remedies one sentence ahead of talking in strange hypnotic tones about their spiritual communication with Martians.

I’ve tried some of those remedies, and while I don’t think they did any harm, they did no discernible good, either.

Likewise, I’ve seen various claims that beet extract does something wonderful but vaguely described, that cranberries are good to treat serious ailments (beyond bladder infections), that mistletoe extract can help cure cancer, and so on. A willow extract was the precursor to aspirin, which is a bonafide wonder drug. So it’s not as if there’s no good stuff out there.

But there have also been snake-oil peddlers throughout history. And it is not true that that which does not kill you makes you stronger. That which does not kill you might leave you horribly crippled, or it might do nothing at all.

Far be it from me to know which claims have merit and which ones do nothing, and which ones make things worse. In this case, though, the danger was slight; I had another remedy on hand which definitely worked, as a fall-back, so why not give it a try?

I did. It worked. And if you suffer from migraine or cluster headaches, and there’s no medical reason why you mustn’t consume ginger, it might well work for you, too.

Which you’ll agree is very good news indeed.

https://www.athensnews.com/opinion/...cle_0240656a-4dc8-11ea-997d-c744b98e94d6.html
 

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Cluster Headaches | Some say psychedelic drugs are the real answer*

by Katherine Ellison | Washington Post | 3 Apr 2021

Imagine a hot poker inside your brain, pressing hard on the back of your eye.

That’s how Bob Wold describes a “cluster headache”: a rare and poorly understood disorder he has suffered for the past 40 years.

The hour-long attacks — four or more a day — occur in “clusters” that drag on for up to three months. Wold has seen neurologists, chiropractors and acupuncturists, tried more than 70 drugs, had teeth removed and root canals, and considered brain surgery.

Nothing helped for the first 20 years, until the day the strait-laced, middle-aged construction contractor tried psilocybin — the active ingredient in “magic mushrooms” — an illegal drug he had previously thought “was just for people who fried their brains.” Ever since, Wold, now 65, has relied on periodic low doses of “’shrooms” to keep his excruciating headaches at bay.

Cluster-headache sufferers are renowned among headache doctors for their desperation. "You'll eat shoe polish if you think it will help," one respondent wrote in a survey.

Patients call the headaches more painful than childbirth, gunshot wounds and kidney stones. They also commit suicide at about three times the rate of the general population, University of West Georgia psychologist and researcher Larry Schor said.

“The pain is so intense that I’ve had some seemingly psychotic thoughts during attacks,” said Schor, who has suffered from the disorder since 1983. “Like maybe if I could take a pliers and start pulling out molars, or if I hammered in the smallest drill bit near my eye, that could relieve the pressure.”

On average cluster headache sufferers wait more than five years before they are properly diagnosed, after which prescribed drugs often fail and may also have serious side effects, including rebound headaches, which can worsen headache pain, due to medication overuse.

Yet “clusterheads,” as some patients call themselves, today have new reasons to take heart — because of the dogged efforts of Wold and Clusterbusters, an activist group he founded in 2002. The organization has a mailing list with more than 11,000 members and a website with advice on everything from suicide prevention to how to sign up for new clinical trials to how to get discounts on new medications to how to obtain, store and grow magic mushrooms for treatment.

Clusterbusters’ out-of-the-box efforts on behalf of its pain-wracked members are “the stuff of movies,” said Rutgers University sociologist Joanna Kempner, who is writing a book on the group. She compares the clusterheads to the 1980s HIV activists who also boldly experimented with unapproved drugs.

“Medicine has ignored these patients for so long that they live in a wild west of treatments,” Kempner said. “They saw the gap in research and did their own research on their own bodies.”

In the process, Clusterbusters has won the hearts — and help — of key allies in academia and the pharmaceutical industry.



Wold and colleagues helped pave the way for the Food and Drug Administration’s 2019 approval of Emgality, an injectable drug that is the first pharmaceutical treatment that can be prescribed to prevent cluster headaches.

The medication deploys a monoclonal antibody to block a protein — calcitonin gene-related peptide (CGRP) — that inflames nerve endings. Eli Lilly originally designed the medication for migraines but devised a higher dose for cluster headaches after interviewing Clusterbusters members, some of whom also participated in its clinical trial, Wold said.

The Clusterbusters’ website hails the Emgality advance as “historical,” but Wold is more excited about new research he hopes will soon confirm his belief that psychedelic drugs can shorten a cluster siege. Later this year, Yale University neurologist Emmanuelle Schindler expects to finish one of the first placebo-controlled studies involving a form of psilocybin to treat cluster headaches.

Schindler not only relied on Clusterbusters to recruit patients for her study but also used key parts of their dosing protocol. After years of self-experiments, many group members believe they have shortened, or “busted,” their clusters with three sub-hallucinogenic amounts of mushrooms spaced five days apart. Schindler is using synthetic psilocybin on a similar schedule, at just 10 milligrams per dose. She said she expects her results to show that “patients know a lot more about their condition and how to treat it than they’re usually given credit for.”

In the patient survey, conducted by Clusterbusters and involving 493 patients recruited from clinics and websites, more than 35 percent of respondents mentioned using “illicit substances.” Based on their responses, Schindler and colleagues suggested that psilocybin and LSD “were comparable to or more efficacious than most conventional medications.”

To cope with headaches in real time, many cluster headache patients use high-flow oxygen therapy, from tanks in their home. Small studies support its safety and effectiveness, and the Mayo Clinic, the American Headache Society and the American Migraine Foundation endorse its use for cluster headaches.

In 2010, however, the Centers for Medicare and Medicaid Services said the evidence for oxygen therapy was “promising” but insufficient to support reimbursement.

Clusterbusters and other headache advocacy groups have been lobbying the CMS ever since. Wold said the federal agency’s refusal to cover oxygen for Medicare and Medicaid patients has had ripple effects, in that many private insurers are unwilling to reimburse it and doctors are less eager to prescribe it.

Yet he added that the CMS has promised to rule on the advocates’ latest appeal and that he hoped for a breakthrough.

“A lot of things are finally coming together, and it’s really an exciting time,” he said.

Up to 1 in 1,000 people, among them more than 300,000 Americans, endure cluster headaches. That’s close to the number of people with multiple sclerosis, a much more familiar disorder. Cluster headache cases include the British “Harry Potter” actor Daniel Radcliffe and former NFL defensive tackle Terrance “Pot Roast” Knighton, who played for the Washington football team in 2015.

Cluster headaches are sometimes confused with migraines, but there are some important differences. Migraines are about 120 times more common and almost always much less severe. Migraine pain can vary in location, but cluster headaches typically involve just one side of the head. And whereas migraines are three times as common in women as men, cluster headaches are as much as six times more common in men.



Brain scans suggest cluster headaches affect the hypothalamus, trigeminal nerve and autonomic nervous system. The hypothalamus controls your internal clock, so its role may help explain why the headaches usually strike at the same time of day, often as a nasty wake-up call. Scientists suspect the involvement of the hypothalamus may also explain why chronic cluster headache sufferers tend to have more frequent attacks when the days are longest, in July and August.

The pain itself is caused by dilated blood vessels pressing on the trigeminal nerve. But no one knows what causes the vessels to swell, and doctors are often helpless to offer safe, effective remedies.

Even as some patients hail Emgality, the new preventive drug, as “a godsend” and “life saver,” others complain of an array of downsides including weight gain, hair loss, faintness, joint pain, brain fog and limited benefit.

The psychedelics certainly also have drawbacks.

They don’t work for everyone, and even at low doses shouldn’t be used by people with problems including heart trouble, schizophrenia and bipolar disorder, Schindler said. The Mayo Clinic warns that "LSD can cause permanent mental changes in perception, rapid heart rate and high blood pressure, tremors, [and] flashbacks, a re-experience of the hallucination — even years later.”

Scientists call magic mushrooms some of the least-toxic and less-addictive recreational drugs, yet some users have reported frightening bad trips, panic, seizures and hospitalizations.

U.S. agencies classify psilocybin and LSD, along with marijuana and heroin, as Schedule I substances, considered to have “high potential for abuse, no currently accepted medical use . . . and a lack of accepted safety for use under medical supervision.”

Despite their risks, however, these drugs, when carefully administered, can help cluster headache patients when nothing else works, some experts said. “LSD and psilocybin are the best we have to offer, although legally we can’t offer them,” psychiatrist John Halpern said.

In 2004, Halpern, then working at Harvard University, was one of the nation’s few researchers studying the medical use of psychedelic drugs. Wold showed him and his colleagues a video of a Clusterbusters member who Wold says was involuntarily committed to a mental hospital because a doctor refused to believe he wasn’t faking his pain.

Halpern decided to help after learning that two staff workers at McLean Hospital, a Harvard-affiliated psychiatric facility, had committed suicide after suffering cluster headaches.

“I wanted to demonstrate that these aren’t drug-seeking individuals but construction workers, lawyers, people from all walks of life yet affiliated in the unluckiest guild of all,” he said. Two years later, he co-wrote a study in Neurology based on interviews with 53 cluster-headache patients who had used psychedelic drugs. Twenty-five of 48 who had used psilocybin and seven of eight who had used LSD reported that the drugs stopped a cluster in its tracks.

Wold’s odyssey in search of relief is familiar to many clusterheads. He was a healthy, 20-something professional, playing football with his young son when he suddenly felt as if his head might explode. The pain vanished after an hour but returned each day over the next few weeks.

For the next 20 years, Wold endured his cycles amid fruitless visits to doctors, until he happened to read an online message by a cluster-headache patient calling himself

“Flash” who said he had found relief with LSD. Shortly thereafter, Wold and a few other people he knew began their private experiments with psilocybin.

Today, Wold keeps his headaches under control mainly with oxygen he pays for out-of-pocket and mushrooms he grows with spores ordered online. The Clusterbusters website describes a “medicinal dose” as one gram or less of dried mushrooms, amounting to half of a mild recreational dose. Wold said it feels like he has had a couple of beers.

He added that he is always happy to hear from others helped by Clusterbusters.

“We’re constantly getting thank-you notes from as far away as Romania, saying things like ‘I’ve been using psilocybin for 15 years and it saved my life,’  he said. “But we don’t really care what people find that’s going to help them. Whatever path they choose, we’re just trying to make it easier and safer.”

*From the article here :
 
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Psychoactive substances as a last resort—self-treatment of migraine and cluster headaches*

Martin Andersson, Mari Persson, and Anette Kjellgren

A summary of psychoactive substances and self-treatment alternatives for cluster headaches (CH) or migraines is presented below.

Overall, the forum discussions revolved around general descriptions on the use of psychedelic tryptamines (not always specified which particular substance) to cure or alleviate these disorders: “Using psychedelics to treat migraines.”/“Treating cluster headaches with psychedelics.”

Psilocybin mushrooms, are commonly utilized for both migraines and CH: “I used magic mushrooms to abort my chronic migraines/I am taking mushrooms for the treatment of cluster headaches.” The incentives and approaches to using psilocybin varied amongst sufferers; some initially used psilocybin for purposes outside the treatment of CH or migraines but were also pleased to experience alleviating effects on these conditions. However, most users did not appear to prefer any psychoactive effects and were solely seeking a possible alleviation of their ailment: “A toned down version of a mushroom trip may be very desirable in many contexts.”

LSD was a common and highly regarded substance for treating both CH and migraines in the reports: “LSD may be the most efficient of the psychedelic treatments.” The data also described other LSD-related substances; 1P-LSD or AL-LAD was mentioned as potential alternatives to LSD. Seeds from four different varieties of flowers, containing the tryptamine d-lysergic acid amide (LSA), like Rivea corymbosa, Argyreia nervosa (Hawaiian Baby Woodrose), or Ipomoea tricolor (Morning Glory) were also commonly used and recommended as a (mostly) legal and more available alternative.

Other psychedelic tryptamines were also frequently discussed as potential treatment options. Attempted self-medication using N,N-dimethyltryptamine (DMT), as well as various novel synthetic tryptamines, was described in several reports: “I have been dosing my girlfriend with 4-ACO-MET or 4-ACO-DMT. It aborted pain level 10 migraine attacks in 30 minutes or less that usually leaves her screaming incapacitated with pain.” Certain synthetic tryptamines were sometimes preferred over psilocybin (mushrooms) since the psychoactive effects were perceived as more manageable: “4-HO-MiPT and 4-HO-MET are said to be not as chaotic as shrooms.”

There were also some discussions on using various combinations of substances and how to test different combinations until the best possible effects were achieved: “The list includes a variety of ”exotic“ tryptamines but also many phenethylamines, particularly in the 2C- family.” A few also mentioned using combinations of prescription medications and non-approved drugs. The recommended administration of prescribed medications was sometimes altered by, for example, grounding pills to a powder to use by nasal insufflation or to exceed the prescribed dosage.

Cannabis was commonly discussed for its potential to alleviate symptoms or lessen the frequency of migraine attacks. Some had used cannabis for unrelated purposes but experienced additional benefits on the headaches.

Other substances, briefly mentioned as potential treatment alternatives, were melatonin, opium, ketamine, cocaine, lidocaine, and MDMA. Also, caffeinated energy drinks (or taurine that is present in most energy drinks) were mentioned: “Energy Drinks - Slam one right when you feel the attack coming on.” Vitamins and supplements were sometimes recommended but were not discussed extensively: “I am getting incredible results from being on the D3 regimen.” Other lifestyle factors like exercise, nutrients, and a healthy diet were also discussed and suggested: “Lots and lots of plant foods like broccoli or carrots and spinach.”

Discussions on preventing episodes of CH and migraines by avoiding certain “triggers” were present in the data. Alcohol, chocolate, fermented cheese, opiates, histamines, carbon oxide, carbon monoxide, sumatriptan, phenethylamines (2C− substances), sudden drops in blood pressure, and changes in weather were discussed amongst the suggested triggers to avoid: “Phenethylamines can trigger terrible migraines, especially 2C-series”/“Sumatriptan caused me to have 51 attacks in 7 days.”

Effects and treatment results

Effective treatment results, for both acute and prophylactic treatment, were reported for several of the substances concerned. (Adverse effects are discussed in the following theme.) Pre-eminently, the psychedelic tryptamines were described as remarkably effective and constituted a majority of the reports. For prophylactic treatment of CH, the psychedelic tryptamines were typically seen as the primary realistic option: “Only psychedelic treatments are shown to stop the recurrence of the cluster cycle.”

Overall, LSD and psilocybin were reported as highly effective for both CH and migraines. Both substances were reportedly effective for prophylactic as well as acute treatment. However, according to several reports, LSD possibly exhibits even higher potential for treating CH. The therapeutic potential of vaporized or smoked DMT seemed a bit more uncertain or complex compared to LSD or psilocybin: “DMT often helps, but sometimes makes it worse.” In one case, a full dose of DMT was effective and reportedly provided lasting prophylactic effects when all else (conventional medication, LSD, psilocybin, and so on) had failed: “For the first time in years, literally, I was not waking up with migraines anymore. Something happened in my brain that day.”

LSA seeds were said to have similar, but possibly less, effects than LSD and psilocybin: “HBWR seeds are not as useful as mushrooms.” The lack of results for some LSA users was sometimes accredited to the high variability in the potency of seeds, not always effective extraction techniques, and a tendency for under-dosing the seeds: “LSA was not actually working, I think I dosed too low, only used a few seeds at a time.” Seeds from R. corymbosa were described as the most efficient LSA containing seed, tough, successful treatment results were reported from other varieties as well: “I started to bust RC seeds and.....miracle. I can say that a total of 2 months of clusters in 5 years is an incredible success.”

Although not as prevalent as LSD or psilocybin, several other synthetic psychedelic tryptamines were discussed and reported as effective treatment alternatives: “I have had great success with acute treating of CH-attacks with 4-HO-MET, 4-AcO-DMT, 4-HO-MiPT, and 5-MeO-MiPT.” The LSD-analog AL-LAD had one report where it was effective for acute migraine treatment.

Microdosing was commonly reported as an effective treatment strategy, not only using psilocybin and LSD but also other psychedelic tryptamines like 4-ACO-DMT and 4HO-DMT. Microdosing appeared to be used for prophylactic effects primarily. Microdosing was reportedly a successful approach for most sufferers, but a few seemed to need fuller doses to have sufficient effects: “My partner could get away with taking sub-hallucinogenic doses to treat her cluster headaches, whereas I need a hallucinogenic dose to abort a migraine, which is unfortunate.”

The “busting” dosing regimen appeared to be an effective strategy for many sufferers: “Thank gosh busting preventatives are working.” Those using the “busting method” reported both acute and preventive treatment results, although it was described as crucial to follow a cyclic dosage scheme to obtain long-term results. Relapses were reported when the dosing regimen was not followed consistently: “Mostly pain-free, except for when I did not take my proper preventative dose.” The busting method was reportedly effective with LSD, psilocybin mushrooms, and various kinds of LSA containing seeds.

There were occasional reports where sufferers did not find relief or any beneficial effects from psychedelics at all. However, in these few cases, there was typically an uncertainty about dose or the potency of the material, and they were often based on single or a few treatment sessions: “I attempted to stop a cluster with what I thought would be an active (and my only) dose of mushrooms.”

The effects of self-treatment with cannabis appeared more contradictory and complex than other substances discussed. While some described expedient relief from the use of cannabis, others reported no benefits and some even found that cannabis could potentially trigger or intensify attacks. “I found out marijuana is awesome for migraines”/“It has done nothing.” Prophylactic long-term effects of regular cannabis use on migraines (not CH) with a lessening in the frequency of attacks were reported: “The weed actually does 100% keeps the tension migraines away for 2-3 months.” Facilitating sleeping during attacks and managing pain were other reported uses for cannabis. Also, it was described how the effects of cannabis served as a distractor from pain and other unpleasant sensations: “Weed helps me to sleep”/“Even when it does not cure the pain, it significantly lessens my care factor about it.”

One report described how cocaine could sometimes be used to stop ongoing CH attacks but did nothing to cure or reduce the frequency of episodes. Caffeinated energy drinks with taurine could also alleviate immediate symptoms: “Regarding Redbull, yes it works.” Melatonin was also occasionally discussed, but no alleviation of pain, or improvement of the conditions, was reported: “Melatonin did nothing for me.”

Conclusions

Self-treatment of headache disorders is discussed in support groups online. Largely, this interest focuses on the use of the currently illegal psychoactive tryptamines, mainly psilocybin, LSD, and related substances. Often, this pursuit is driven by desperation, and these substances are considered a last resort. It was reported how several of the substances used can serve as potential treatments for migraine and CH. However, this population exposes themselves to risk by self-experimenting with illegal or sometimes new and unknown psychoactive substances. Given the vulnerability of this population, their situation is important to note and to consider seriously. This study also highlights the importance of the reciprocal knowledge production process and harm reduction content emerging from interactive drug forum discussions. More scientific studies are needed to develop safe and effective drugs. To minimize harm and to cater to the needs of this patient group changes or exceptions in legislation and other ethical considerations can be a required measure.

*From the article here :
 

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New study is the first double-blind, placebo controlled test.

Single dose of psilocybin has a lasting therapeutic effect on migraine headache, study*

by Eric 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 :
 

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Sumatriptan - Fast relief from migraine or cluster headache!*

by Michael Stewart | patient.info | 24 Aug 2020

In people with migraine, it is thought that some chemicals in the brain increase in activity and as a result parts of the brain then send out confused signals which result in the symptoms of headache and sickness. Why people with migraine should develop these chemical changes is not clear. Many migraine attacks occur for no apparent reason, but for some people there may be things which trigger an attack, like certain foods or drinks.

Cluster headaches consist of attacks of severe one-sided pain in the head. Typically, a number of attacks will occur over several weeks and then pass. It may then be weeks, months or years until the next cluster of headaches develops.

Sumatriptan belongs to a class of medicines known as 5HT1-receptor agonists. They are also known simply as triptans. Triptans work by stimulating the receptors of a natural substance in the brain, called serotonin (or 5HT). This eases the symptoms of migraine and cluster headaches.

There are two strengths of Sumatriptan tablet available (50 mg and 100 mg), one strength of injection (6 mg/0.5 ml) and one strength of nasal spray (10 mg/actuation). The injection is usually prescribed for people with cluster headaches, whereas the injection, spray or tablets may be prescribed for people with migraines.

Sumatriptan 50 mg tablets can be purchased from pharmacies for the treatment of migraine headache. The pharmacist will need to check that the medicine is suitable for you to take.

Before taking Sumatriptan

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking Sumatriptan it is important that your doctor knows:​
  • If you are aged over 65 years or under 18 years.​
  • If you are pregnant or breastfeeding.​
  • If you have a heart condition such as angina, or if you have had a heart attack.​
  • If you have high blood pressure (hypertension).​
  • If you have circulation problems.​
  • If you have any problems with the way your liver works or with the way your kidneys work.​
  • If you have ever had a stroke or a transient ischaemic attack (this is also referred to as a TIA, or 'mini-stroke').​
  • If you have ever had a fit (seizure).​
If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have had a bad reaction to a sulfonamide antibiotic (such as co-trimoxazole or sulfadiazine).

If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

How to take Sumatriptan

Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about Sumatriptan and a full list of the side-effects which you may experience from taking it. It will also provide you with a step-by-step guide and diagrams to show you how to use the preparation you have been supplied with. If you are still unsure what to do, ask your pharmacist for further advice.

Your dose will be on the label of the pack. Take Sumatriptan exactly as your doctor tells you to.

If you are taking tablets: take one (50 mg or 100 mg) tablet with a drink of water, as soon as the headache phase develops. You can take Imigran Radis® tablets stirred into a small amount of water. If your migraine at first improves but then comes back, you may take a further dose, providing it is at least two hours after the initial dose. If the first tablet has no effect, do not try a second dose for the same attack, as it is unlikely to work.

If you are using the injection: inject one dose as soon as the headache develops. If your headache at first improves but then comes back, you may use one further dose, providing it is at least one hour after the initial dose. Do not use more than two doses in 24 hours. If the first dose has no effect, do not try a second dose for the same attack, as it is unlikely to work. The needle shield may contain natural latex rubber.

If you using the nasal spray: use the spray as soon as the headache phase develops. If your migraine at first improves but then comes back, you can use the spray again providing it is at least two hours after your first dose. Do not use the spray more than twice in 24 hours. If the first spray has no effect, do not try a second dose for the same attack, as it is unlikely to work.

If you have migraines

Sumatriptan is used to treat headache pain during a migraine attack, not to stop the pain from coming on. You should wait until the migraine symptoms start to develop, rather than taking it when you feel that a migraine may be developing.

Do not take other migraine treatments (such as other triptans or ergotamine) at the same time as Sumatriptan.

Some people may benefit from taking a non-steroidal anti-inflammatory painkiller (such as naproxen) in addition to Sumatriptan. Your doctor will advise you about this if it is recommended for you.

If you find that Sumatriptan does not relieve your migraine, make an appointment to discuss this with your doctor, as an alternative medicine may be more effective for you.

It may help to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge and it may be possible for you to avoid some of the things that trigger your migraine attacks.

Sumatriptan is used to treat migraine attacks once the pain has started, but there are other medicines available that may help to reduce the number of migraine attacks. If you have migraines frequently, discuss this with your doctor.

Some people who get frequent migraine attacks are in fact getting medication-induced headache. Medication-induced headache (also called medication-overuse headache) is caused by taking painkillers or triptans too often. If you use Sumatriptan or painkillers on more than two days a week on a regular basis, you may be at risk of this. You should talk with your doctor if you suspect it.

If you have cluster headaches

Sumatriptan is usually given by injection for cluster headache, as it provides pain relief in about 5-15 minutes in most people.

You will be shown how to use the injection. You should use it as soon as a headache occurs. The adult dose is one 6 mg injection for each headache. If you get more than one headache a day, the maximum dose you can have in 24 hours is two 6 mg injections. You must leave at least one hour between the two injections.

You may also be prescribed another medicine to try to prevent the headaches from occurring. Preventative treatment is often taken over the period of the cluster headaches and is then stopped, although some treatments are taken longer-term.

Can Sumatriptan cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with Sumatriptan. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common side-effects

What can I do if I experience this?​
  • Feeling dizzy, sleepy, or tired - If this happens, do not drive and do not use tools or machines​
  • Feeling sick (nausea) or being sick (vomiting) - Stick to simple foods​
  • Feelings of tightness or heaviness, particularly in the throat or chest - If the pain is intense, do not take any further doses and speak with your doctor about it as soon as possible​
  • Tingling feelings, feeling flushed, feeling warm or cold, aches and pains, increased blood pressure, feeling short of breath - If any of these become troublesome, speak with your doctor​
  • Unpleasant or bitter taste (if using the nasal spray), and injection site reactions (if using the injection) - These should soon pass​
  • If you experience any other symptoms that you think may be due to the medicine, speak with your doctor or pharmacist for advice.​
*From the article here :
 

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Ketamine cuts migraine pain in half

by Jesse Hicks | VICE | 21 Oct 2017

Researchers are studying the drug as a therapy for migraines that haven't responded to other treatments.

Migraines are hell and researchers are looking into a new solution: Ketamine, the psychedelic-turned antidepressant, may also help alleviate the crippling headaches for people who otherwise don't respond to treatment.

That's according to new research presented this weekend at the annual meeting of the American Society of Anesthesiologists in Boston. The study, conducted at Thomas Jefferson University Hospital, involved 61 participants with migraines, the chronic throbbing or pulsing headaches that cause moderate to severe pain, and often include sensitivity to light and sound. Attacks can be debilitating, causing nausea and vomiting for some people.

About 12 percent of Americans get migraines—they're 3 times more common in women than men. The study consisted of people whose migraines hadn't responded to other treatments; that's known as having "intractable" migraines. People were referred by headache physicians, or neurologists who specialize in treating headaches, between January 2014 and December 2016, says study co-author Eric Schwenk. "Occasionally some patients with migraines have heard about Ketamine therapy, and request to be given the treatment after talking to their headache physicians," says Schwenk, who's also director of orthopedic anesthesia at Thomas Jefferson University Hospital.

If you are only familiar with Ketamine's reputation as a psychedelic, you might be surprised to hear that migraine patients are clamoring for it. Ketamine is a well-known, safe pain reliever at low doses and an anesthetic at higher doses. Meanwhile, evidence is growing about its value as a fast-acting antidepressant, offering benefits in minutes that other drugs need weeks to provide. There's a reason emergency room doctor and Tonic contributor Darragh O'Carroll called it "my favorite medicine."

Because of Ketamine's potential as a migraine treatment, at least one sufferer flies to Los Angeles several times a year simply for pain relief. At Jefferson, patients receive an intravenous infusion of Ketamine continuously for 3-7 days under close supervision. Those who have never had the drug before may undergo some other tests to establish a baseline, Schwenk says.

Among 61 patients included in the study, almost 75% saw an improvement in their migraine intensity. At admission, the average migraine headache pain rating was a self-reported 7.5 on a scale of 0 to 10. On leaving the hospital, the average pain rating was 3.4; less than half of the initial amount. Patients stayed 5 days, on average, and they experienced generally mild side effects including blurry vision and nausea and vomiting.

"Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term," Schwenk said in a statement. "Our work provides the basis for future prospective studies that involve larger numbers of patients." The current study is retrospective, collecting results from a number of previous individual cases rather than a prospective study, which would enroll subjects at the same time under controlled conditions.

Richard Lipton, director of the Montefiore Headache Center at Albert Einstein College Of Medicine, echoed that sentiment. He told Tonic he's encouraged by the results. "As Ketamine is an approved drug, in expert hands, this treatment is an option for intractable patients," he says. "Future studies should more rigorously assess the short and long-term benefits of Ketamine using blinding and a placebo control groups." (e.g. there should be a group of patients who get an infusion of a placebo, and the researchers shouldn't know which group is which.)

One question future research might address why some patients respond to Ketamine, while others don't—about a quarter in this study didn't respond. There's a clear division between the two, but, Schwenk says, "We have not been able to identify any factors that predict response yet."

The hospital plans to open an infusion center which can treat more patients and further the research. Schwenk believes Ketamine may help with other painful chronic conditions, such as fibromyalgia and complex regional pain syndrome. Schwenk and his colleagues are betting they've just begun to unlock the potential of Ketamine.

https://tonic.vice.com/en_us/article...tant-migraines
 

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Montel Williams chats with Julia Jacobson, CEO of Aster Farms, on this epsiode of Let’s Be Blunt. Julia suffered from chronic migraines and began using cannabis medicinally in 2016, particularly strains high in CBG, finding immediate relief. Cannabis allowed her to stop taking a cocktail of prescriptions and return to a normal life. Shortly thereafter, her and her husband founded Aster Farms in northern California based on their belief in cannabis as a medicine. Their focus as a company is to curate craft cannabis products, cultivated in an environmentally and community sustainable manner.​
 

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Cannabis found to reduce headache pain by nearly half

by Washington State University | Medical Xpress | Nov 25 2019

Inhaled cannabis reduces self-reported headache severity by 47% and migraine severity by 50%, according to a recent study led by Carrie Cuttler, a Washington State University assistant professor of psychology.

The study, published online recently in the Journal of Pain, is the first to use big data from headache and migraine patients using cannabis in real time. Previous studies have asked patients to recall the effect of cannabis use in the past. There has been one clinical trial indicating that cannabis was better than ibuprofen in alleviating headache, but it used nabilone, a synthetic cannabinoid drug.

"We were motivated to do this study because a substantial number of people say they use cannabis for headache and migraine, but surprisingly few studies had addressed the topic," said Cuttler, the lead author on the paper.

In the WSU study, researchers analyzed archival data from the Strainprint app, which allows patients to track symptoms before and after using medical cannabis purchased from Canadian producers and distributors. The information was submitted by more than 1,300 patients who used the app over 12,200 times to track changes in headache from before to after cannabis use, and another 653 who used the app more than 7,400 times to track changes in migraine severity.

"We wanted to approach this in an ecologically valid way, which is to look at actual patients using whole plant cannabis to medicate in their own homes and environments," Cuttler said. "These are also very big data, so we can more appropriately and accurately generalize to the greater population of patients using cannabis to manage these conditions."

Cuttler and her colleagues saw no evidence that cannabis caused "overuse headache," a pitfall of more conventional treatments which can make patients' headaches worse over time. However, they did see patients using larger doses of cannabis over time, indicting they may be developing tolerance to the drug.

The study found a small gender difference with significantly more sessions involving headache reduction reported by men. The researchers also noted that cannabis concentrates, such as cannabis oil, produced a larger reduction in headache severity ratings than cannabis flower.

There was, however, no significant difference in pain reduction among cannabis strains that were higher or lower in levels of tetrahydrocannabinol (THC) and cannabidiol (CBD), two of the most commonly studied chemical constituents in cannabis, also known as cannabinoids. Since cannabis is made up of over 100 cannabinoids, this finding suggests that different cannabinoids or other constituents like terpenes may play the central role in headache and migraine relief.

More research is needed, and Cuttler acknowledges the limitations of the Strainprint study since it relies on a self-selected group of people who may already anticipate that cannabis will work to alleviate their symptoms, and it was not possible to employ a placebo control group.

"I suspect there are some slight overestimates of effectiveness," said Cuttler. "My hope is that this research will motivate researchers to take on the difficult work of conducting placebo-controlled trials. In the meantime, this at least gives medical cannabis patients and their doctors a little more information about what they might expect from using cannabis to manage these conditions."

 
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