Cannabis (marijuana) for cluster headaches

Smoking marijuana and taking its legal medicinal derivative, dronabinol helped one patient with cluster headaches, according to a report from the Montefiore Headache Clinic.  Dronabinol is approved for the treatment of nausea and loss of appetite.  The effectiveness of smoking marijuana or taking dronabinol for the relief of pain has been reported by many patients, but never proven in large trials.  I generally discourage patients trying marijuana for the relief of any symptoms, unless they have tried and failed traditional medications and they have already tried marijuana and it did help.  Marijuana not only has many negative effects on the body, but can be also contaminated by other harmful substances.  Cluster headaches can be extremely intense and at times lead patients to thoughts of suicide.  In view of this report it seems reasonable to try dronabinol in patients who failed Imitrex injections, oxygen and preventive drugs, such as high dose of verapamil, lithium, and topiramate.

38 comments
  1. Larry says: 03/02/201011:09 pm

    It has absolutely worked for me. In 10 years of self medicationg with alcohol (read raging alcoholic) and stuffing lidocain soaked q-tips, using anbesol when I ran out; only to have the pain increase in intesity, duration and frequency I smoked pot. It keeps me headache free. I had headaches two to five times a day from a half hour to three hours in duration. Marijuana cured the pain. But it doesn’t have to be smoked, it can be vaporized. And although I agree with legalization, I feel that a medicinal restriction still leaves a black market it for it as a drug.

  2. Tara says: 03/26/201011:56 am

    I agree, it has definitely worked for me too, and I’m one of those people who have gone to see a Neurologist. I was prescribed dissolving Imitrex pills as well as Topiramate. I take 3 pills at night, 25mg each, and I’m still getting headaches and migraines, granted they are definitely less frequent but still getting them nonetheless. Marijuana somehow relieves the pain and the tension behind the eyes – which is where a lot of my headaches are. If anything, it sometimes just allows me to fall asleep without vomiting and sleep the migraine away.

    What do you suggest for someone who is taking Topiramate and Imitrex and still getting headaches/migraines? Perhaps I should come in…

  3. Dr. Mauskop says: 03/26/20103:18 pm

    There are many good alternatives to topiramate (Topamax) and Imitrex. You may want to come in for a consultation, but meanwhile you can ask your doctor (and read up on) about magnesium, CoQ10, butterbur, Botox injections, Migralex (see Migralex.com)

  4. Nicole says: 11/15/20108:17 pm

    I have non-responsive clusters. I went chronic almost two years ago, and to date have tried over 60 different medications, and go in about 1-2 a month for some block, burn, poke or prod. I’ve tried all of the common and not so common treatments so far (my kids think it’s funny that my eyebrow won’t move after the botox)..LOL.

    I have started researching this subject since it is legal in Michigan, and everything else has failed. One neuro I see has joked (I think he was joking) about writing a paper on me, and I’ve frustrated the pain clinic and neuro I’m currently seeing because nothing works. If this will work, I’m at my wits end and willing to even try this.

  5. Dr. Mauskop says: 11/15/201010:54 pm

    We’ve had good results with the vagus nerve stimulator (VNS) in refractory chronic clusters, although we’ve tried it only in 2 patients. We gave it a try because it is approved for refractory epilepsy and depression and we do use anti-epilepsy and antidepressant drugs for headaches.

  6. Jeffrey Reisman says: 02/04/201112:23 am

    Ive had clusters for about 3 and half years now. Always get shadows which is an indication that one may be coming so if possible i run too oxygen ( in the left temple and all around the eye and in it). Ive tried imitrex, migranol, topamax (topiramates) – nothing seemed to stop them. But i swear by the oxygen 95 percent of time it kills them. The Cannabis is all good but im thinking it can casue headaches as well. If you havent tried the oxygen give it a shot.

  7. Billy Chris says: 04/28/20119:07 am

    As a chronic Cluster attack vicitm and a pot head i think i can answer the question if pot helps cluster headaches.
    It does help with the migraines, and sleep.
    But i bleive it triggers clusters. Its kinda a duble edge sword.
    I migraine can turn into a cluster, so then you think you can smoke to get rid of the migraine, and you can, and SOMETIMES wont trigger the cluster and releave your migraine, but sometimes you smoke while not in pain and a cluster comes, so as a pot smoker <I think it best to cut it out while having your attacks, I went 8 years with no pain while smoking, but now im in my cycle and i think the pot triggers clusters. What i would like to know is how long does it take to get the pot out of your system if it is causing the clusters?
    becasue if im still getting cluster and migraines while NOT smoking, I might as well smoke to relief the Migraine. Overall, this pain SUCKS. I feel for everybody who gets Cluster, Migraines are nothing compared to them.

  8. Chris says: 06/13/20115:19 pm

    I was thinking about trying marijuana for this because I’m not having much luck. Imitrex injections are working but you can only have a couple injections a day. I’ve been getting 4-5 clusters. Oxygen works some of the time, depending on intensity of the headache. I don’t want to try the weed if it is going to give me headaches. I guess I’ll try it. Can’t be much worse then what i’m dealing with now.

  9. Aron says: 06/15/20118:52 am

    What’s this talk about cannabis causing headaches? I haven’t ever heard of anyone getting pain from intaking cannabis. I’ve seen that someone complained about the health risks of cannabis, but have you compared them to the health risks of other drugs suggested here? Cannabis have no major adverse health risks, it is by far one of the safest drugs that exist, ESPECIALLY if you vaporize it (doing so eliminates all of the tar and carcinogens contained in the plant matter)

  10. orange 1 says: 08/07/20119:04 pm

    @larry

    self medicating with alcohol? your retarded! alcohol triggers cluster attacks in almost ALL patients

  11. stefan says: 10/07/201111:35 am

    Well I suffer from chronic cluster headache and I smoke marijuana every single day… After I’ve begun smoking my headache amount has increased but the intensity has decreased…. So I think the dilemma is, do you want a higher amount and mild headaches. or less and more intense headaches

    I choose no. 1 ….

    But I think you guys should try it out and tell about your experience.. One thing is sure it won’t. Kill you ;)

  12. Wes says: 12/21/20111:01 am

    I’ve had chs for almost 30 years, recurring usually every December- January lasting 8-10 weeks. I believe I have tried it all imitrex works best for me but I cannot I would be taking likely 30 shots a week in a bad cycle. I did some reading and decided to try mj. I found it not to take the headache away, but rather engage in a see-saw battle that was largely won by the ch. I’m not experienced with medical grade mj or weed in general, so dosing became an issue. When the pain did not relinquish, I toked a bit more… I ended up pretty twisted, clammy, and in a world of pain. Finally after two hours the ch left, only to return twice that night. My experience is that mj is not a successful abortive option. Good luck. My heart goes out to all sufferers and supporters.

  13. Fellow CHer says: 12/21/20115:54 am

    @Nicole,

    Nicole, have you tried bottled medical oxygen? Have you tried it administered correctly? Don’t waste your time &/or money on an oxygen concentrator, they
    don’t work for CH [cluster headache] sufferers.

    If you use the correct mask [non-rebreather] & the correct Liters Per Minute amount [15 LPM is the average flow rate for most CH patients], you will have much success.
    75-80% of CH sufferers have had/have great results with O2 therapy!
    See the web link/site below for correct CH O2 treatment/administration.

    http://www.clusterheadaches.com/O2/index.html

    Good luck & pain free to you.
    :-)

    *SAFETY WARNING:
    You must have a place that has NO open flames- NO SMOKING cigarettes, NO candles, NO fire! Oxygen can saturate your clothing, bed sheets, etc. and then catch on fire when you light a match. Be very careful and wait at least 30 minutes after using oxygen before smoking.

  14. headpain says: 05/13/20123:17 pm

    I get clusters in the spring. I honestly think MJ triggers it. I layed off the MJ and tried Verampil. It worked for me. I’m looking into getting oxygen but its taking time to get. For Migrianes MJ works for clusters I found it to intensify the pain. I took a break and got a full nights sleep without the demons fighting over my eye. Take a break from MJ if you are getting CH. Smoke tough for migraines. Good luck I know how much it hurts and I hope this helps

  15. SorryBadEnglish says: 05/18/20125:06 pm

    Hi!
    If I smoke or vaporize bad bud, not riped well or strain is not medical I dont get relif from pain but sometimes it helps to sleep. Some bad cannabis can give terrible headache but not that burning hell from migraine/cluster?
    Well done and flushed bud does the trick and pain goes away hitting bong or vapo, after that by sleeping 2-4hours. About 0,2g is enough when its good. Otherwise it have to be taken days before attacks. I consider myself lucky to get “vacation” from chronic pain. Im seeing doctor, I dont know if I have cluster but pain is like from cluster but last’s longer at one time. I have tested litium and topamax +bloodpressure pills and triptamines. Now I have to try O2. I’m quitting smoking bud so attacks can come and I can test if O2 helps. Attacks starts about in 7 days when im totally without taking any dose of cannabinoids.
    Without Cannabis, pain is chronic and I have 4 seizures month and 1 seizure last’s 3 days with no sleeping. All of my life. I have tough that is it cannabis causing this, but to me it’s impossible cos this started way before I saw cannabis.
    To me cannabis really helps and makes life normal. It have side-effects but not that serius as Topamax or other…
    Try to hang on there! Try O2, I got it in 2 weeks and using it is easy!

  16. Tae says: 05/31/201210:23 am

    I am 16 years old and have been suffering from chronic headaches for about 4 to 5 years now. I have them everyday and usually all day in all intensities. I have been to two neurologists and neither of them can figure out what is wrong. I do not have migranes. I have been on all types of medications such as topamax, nortryptaline and gabapentin. Nothing has worked. I also have major sleep problem and was told to take melatonin and see if that solved both problems. It hasn’t. I dont even know what its like not to have a headache anymore. I have smoked pot and that has helped both issues. The only down side is that when i am not smoking my headaches come back. So it is only a temporary fix. I am tired of being in pain but it is a normal thing in my life now, I am so used to having headaches. Ihave never tried the foods with pot in them but I think that may be a better alternative than smoking all the time.

  17. Dr. Mauskop says: 05/31/201210:51 am

    Ask your doctor about having a sleep study to find out if you have a sleep disorder. Many sleep disorders can cause or worsen headaches. You can also ask about taking magnesium and CoQ10 supplements. Botox injections can be also very effective.

  18. Corey says: 07/20/20123:29 pm

    I have been suffering from chronic cluster headaches for about 4 years. I have been prescribed just about every medication mentioned by others. Although I have never tried the mj, I can speak on the oxygen, it does help mainly when u get on it when the cluster is just beginning, if u wait to long it doesn’t always help. I also take the imitrex for the MASSIVE ones and that normally works within fifteen minutes after the injection, but nothing is foolproof. I also take 960 mg’s of verapamil, and that does lower the frequency. That is the only script which was gradually increased to that dosage by my neurologist that really helps the frequency. It is a very tough life to live with this condition, but my advice to all sufferers is never give up.

  19. RJ says: 08/18/20125:34 pm

    I have been dealing with ch for over 10 years now. After 2 years of no headaches they have come back with a vengeance and the longest stretch I have ever had. Went to the doctor and he put me on prednisone. That pretty much worked for the time I was taking them and then when they were done I got slammed again. He gave me a prescription for Maxalt (rizatriptan benzoate ) and they seem to work if you catch the headache at the very beginning. Wait too long and they don’t do a damn thing. Tried MJ a few times and on those nights I had milder 15 minute headaches. I am afraid of MJ because I fear that it might make them more intense. I just never know if I am going to have a bad one or a mild one. Even with a day long shadow I may not get one at all. My heart goes out to all of you sufferers as only we really know the unbelievably intense pain these entail. The good news is my doctor said they probably will be gone when I turn 60. Wonderful.

  20. Dr. Mauskop says: 08/24/201212:35 pm

    There are many better options for cluster headaches than marijuana. Injections of sumatriptan (Imitrex) work better and faster, so it gives people a wider window of opportunity to abort a cluster attack then any tablet. Preventive treatments with magnesium, verapamil (high dose is often needed), other drugs and even Botox injections might work. Unfortunately, there is no definite age when cluster (or migraine) headaches go away, although they do tend to subside with age.

  21. David says: 09/13/20129:26 pm

    I have had clusters on and off since 1997. I did get relief from Immitrex but it didn’t prevent the headaches. I had a heart attack in 2002 and since then I cannot take triptans because I have a stent in my right coronary artery. Using triptans now will kill me. Anything else we have tried doesn’t work for me. I have tried Midrin, several blood pressure meds like verapimil and altace with no success. I tried medical marijuana in the beginning of 2010 and it broke the cluster. I have been headache free since then. I will stick with it because I know it works. I have a medical marijuana card. One of these headaches is too many and I am not going to play around with them.

  22. hanyuu says: 09/17/20123:21 pm

    I’m having many hours long headaches few times a month, and they’re accompanied with nausea – it doesn’t hurt too much but i just feel too bad to do anything besides lying on bed. And i found cannabis help it a lot. Though it doesn’t reduce amount of pain (maybe a bit), it helps great with nausea and also helps to relax, stop thinking about feeling shitty and co concentrate on task so i just ignore the pain, it just doesn’t bother me.

  23. [...] seems to help some patients with migraine and cluster headaches. However a new study suggests that it has more negative effects than previously thought. We know that [...]

  24. thomas says: 11/05/201211:43 pm

    i have had cluster headaches since i was in second grade and got a concussion, they have been apart of my everyday life and feel like they are slowly killing me, they wake me up from my sleep leaving me disoriented… life really sucks with these particular headaches, i am in high school and having these headaches while trying to learn is horrible. it just cant happen for me. i have tried many medications and none have seemed to help, i have been researching medical cannabis for awhile now and have been interested in trying it. hoping it will stop my headaches. but because i am under 18 will i be able to acquire one in Arizona? please let me know

  25. Dr. Mauskop says: 11/07/20125:57 pm

    You should ask your doctor about trying high doses of verapamil or Botox injections.

  26. dave says: 11/09/20126:05 pm

    I have had cluster headaches for 15 years with the last thirteen being chronic-at least five per day. I have been to neurologists, had CAT scans and MRI’s. I have been on any and all legal medications that are indicated for clusters. I did get some relief while on narcotics-not in the occurrence of the headache but in the tolerance to the pain. However, doctors are less willing to prescribe narcotics for clusters, so the last three years I have been on ibuprofen. Anyone who has had a real cluster headaches, knows full well that they DO NOT respond to ibuprofen. So, after the recent Presidential elections, I noticed that Colorado passed to legalize marijuana, and thought that since I am not getting relief the traditional way, maybe I should try something like marijuana. I don’t know? Anyone with advice please let me know.

  27. mike says: 12/03/20124:47 am

    In going through chronic ch episodes at this very moment..today I almost stabbed myself in the head to release to pressure and end the pain and even thought about digging my eye out..nothing works,I dnt have insurance,and I just don’t know what to do..I feel like I’m dying..I’m typing now between episodes because they are unbearable and I wouldn’t be able to type..what do I do??? Is there any free place or person i can see? I dnt want to smoke because I’m looking for jobs and they wont consider my condition

  28. Dr. Mauskop says: 12/03/20124:05 pm

    Mike,
    If you live in NYC I will see you for free – call the office for an appointment. I know that cluster headaches headaches cause the worst pain imaginable.

  29. greg says: 01/03/20137:12 pm

    Im 51 yrs old, had chronic clusters from 18yrs old till i was 38. the last 13 yrs everything changed to where i was only getting clusters twice a yr for maybe a weeks time! I smoked a little weed when i was in college but stopped because triggered the clusters! Anyway now im 51 and my business went in the toilet and alot of personal family problems as well, so at a party one nite i smoked alittle MJ. No cluster reprocussions, so I started smoking once a week for a couple of months, kinda of a pressure release for me from all the stress! then boom!!!One day Clusters are back. In a bad cycle now every day for past 6weeks! been on prednisone but have to get off it soon because its killing me! My question to anyone out there, Will this CH cycle go away and will i get back to (so called normal?) How long will the THC stay in my system and is that whats causing these clusters, is the THC like a plaque in my arteries? causing clusters? Havent smoked for 25yrs, I go and try a little MJ to ease my stress, did i f… myself for the next 25? Any one with some answers, I would appreciate the help!

  30. Dr. Mauskop says: 01/04/201311:46 am

    Marijuana does not stay in the body for long and should not cause persistent cluster headaches. Your experience suggests that marijuana can worsen cluster headaches and considering that it is addictive and can cause long-term brain problems if used regularly, it is better to stay away from it.

  31. gregg says: 01/04/20134:27 pm

    Marijuna is a vasal dialateor, could it still be causing my problem with clusters? I have not touched it since the clusters started!I am absolutly never going to touch it again! but why after so many years of not having clusters have they come back with such a vengence?Headaches for the past 6 weeks! The prednisone is keeping them some what managable from full blown attacks but still my head hurts day and nite! No severe eye stabbing pain , but cant stay on prednisone for ever! I have gone threw the montitiore headache clinic, stamford headache clinic meds oxygen ect years ago. Done the injections, nerve blocks, multi meds, god i am hoping this is not the beginning of the end again! The past 13 yrs I would get clusters for a week or two, go on pred and they would be gone! Now cant shake them! Like I said when I was 18 to 38 my cycle was oct to march every yr! Any one have any good news or insight as to why they come back .
    .

  32. gregg says: 01/04/20134:31 pm

    By the way, thankyou Dr.Mauskop for the response to my blogs, greatly appreciated. Is there any supplement I could try during this difficult time, to help with these CH.

  33. Orlando says: 01/06/201311:49 pm

    I’ve suffered from cluster headaches since the 4th grade and I am 36. I did notice a decrease in frequency during law school when I made some lifestyle changes. I began to eat healthier, avoiding sodium nitrates, deli meats, red wine, beer, and I also began running 45 minutes everyday. But they never truly went away. I think the longest I’ve gone is 2 years. But right now, I am in the middle of a cluster.

    When I am going through a cluster, I become hypersensitive to triggers that normally are not triggers. For example, when I am not going through a cluster, I can enjoy red wine, beer, pot, anything. But during a cluster, I cannot even smell these things.. Certain scents (like my mom’s perfume, Beautiful or cheap hand soap) will immediately trigger a cluster. My prayers go out to all of you who suffer from this. They say its the worst pain known to man. I’m not sure about that, but I think the inaccessible location of the pain and the restlessness it causes is what makes it pure torture. I pray that I do not get anymore and that the cycle is over

  34. Dr. Mauskop says: 01/10/201311:18 pm

    Magnesium oxide, 400 mg and Boswellia (Nature’s Way brand tends to be better than other) 1 capsule three times a day are worth trying for cluster headaches.

  35. gregg says: 03/02/20145:33 pm

    hi, I wrote to you last yr, about trying cannabis after 30 yrs and it triggered my clusters to come back. This year 12/28/13 I had a verbal screaming and yelling argument, lost total control, completely out of character for me, but i blew a gasget! felt like something popped in my head! cluster headache free for a year they were back the next day. went on prednisone on a taper regiment and by middle of 1/15/14 they were tolerable. down to 5mg on 2/20/14 . Woke up next day, and my back of my head is burning unfire and the eye stabbing trying to bust threw! went back on pred at 80mg on 2/25/14 to try to abort with almost know relief? head is in crushing pain! after 30 yrs pred always helped! I do not understand? the prednisone always made it tolerable and now nothing? could after all these years I got a clot or busted a blood vessel in my head from the sreaming outburst? and something else is causing the pain and the clusterheadaches?

  36. Dr. Mauskop says: 03/02/20147:31 pm

    It is not likely that there is another cause for your cluster headaches, but since they are not responding to your usual treatment, an MRI and blood tests might be necessary. I would suggest seeing your doctor ASAP. You may also want to ask your doctor about getting an occipital nerve block or trying prophylactic medications, such as verapamil. For acute pain, sumatriptan (Imitrex) injection is the best.

  37. gregg says: 03/02/20148:31 pm

    had a physical last week. 53yr male all came back good. PSA, cholesterol, ect. what type of blood test are u referring too? should I ask my doctor for a neurologist? So I can get a MRI?And will the MRI tell if I have a anuryism or clot? headaches have been basically good for so many years don’t have one down here in south florida! just don’t understand why they came back?

  38. Dr. Mauskop says: 03/02/20149:33 pm

    Unfortunately, I don’t have information to give you intelligent advice and in general I cannot give anyone any specific advice. Mayo Clinic in Jacksonville is a good place to go to.

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