Study register / Pain / Migraine

Migraine

4 curated studies · 2 key studies · mechoulam.de

A first controlled trial shows that vaporised cannabis relieves acute migraine attacks better than placebo, supported by retrospective data. The evidence base as a whole is still young.

Rating scheme

The letter rates the quality of a study, independently of its type. Every study type can receive any grade: a review can be B or C when it is small or weak, and an RCT can be S. The grade is a synthesis of study design, journal authority and clinical bindingness:

S
Highest evidence, large, methodologically first-rate studies or S3 guidelines
A
Strong evidence, solid, meaningful studies with a clear result
B
Moderate evidence, smaller or methodologically limited studies
C
Weak evidence, preliminary, indirect or contradictory findings
D
Lowest evidence, exploratory hints, single cases or expert opinion

Quality profile per study

To the left of each study there is a profile of four features, it shows the differences within a letter class.

Sample size ★
Number of participants (RCT) or included studies (review).
Blinding
Double-blind, single-blind or open-label.
Effect size
Clear benefit, mixed, no benefit or harm.
Citations / year ★
Age-adjusted citation frequency.

Key studies

2
  1. 01
    A
    Vaporized cannabis versus placebo for acute migraine: A randomized, double-blind, placebo-controlled crossover trial.
    Schuster et al. ·2026 ·Headache
    Read
  2. 02
    B
    Effects of Medical Cannabis on Migraine Headache Frequency in an Adult Population
    Rhyne et al. ·2016 ·Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
    Read

Randomised Controlled Trials

Efficacy and safety evidence from controlled interventional trials.

1
A
Sample size ★★★★★
Blinding Double-blind
Effect size Clear benefit
Citations / year ★★★★★
● Key study
Schuster et al. ·2026 ·Headache
2 citations

Vaporized cannabis versus placebo for acute migraine: A randomized, double-blind, placebo-controlled crossover trial.

Design
RCT
Sample
n = 92 Pat.
Key finding

The combination of 6% THC + 11% CBD showed superiority over placebo for the primary endpoint pain relief after 2 h (67,2% vs. 46,6%) with sustained benefits up to 48 h.

Summary

RCT (crossover) with n=92 migraine patients, 247 treated attacks; vaporized cannabis 6% THC + 11% CBD vs. placebo. Primary endpoint pain relief after 2h: THC+CBD 67,2% vs. placebo 46,6% (OR 2,85 [95% CI 1,22–6,65], p=0,016). Pain freedom after 2h: THC+CBD 34,5% vs. placebo 15,5% (OR 3,30 [1,24–8,80], p=0,017). Most bothersome symptom freedom after 2h: THC+CBD 60,3% vs. placebo 34,5% (OR 3,32 [1,45–7,64], p=0,005). Sustained pain freedom after 24h and sustained symptom freedom after 24h and 48h significantly superior. THC-dominant (6% THC) superior for pain relief (68,9% vs. 46,6%, OR 3,14 [1,35–7,30], p=0,008), but not for pain freedom. CBD-dominant (11% CBD) not superior vs. placebo. No serious adverse events.

DOI 10.1111/head.70025 ↗

Real-World Evidence and Observational Studies

Data from routine clinical care, registries and mandatory reporting.

2
B
Sample size ★★★★★
Blinding —
Effect size Clear benefit
Citations / year ★★★★★
● Key study
Rhyne et al. ·2016 ·Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
91 citations

Effects of Medical Cannabis on Migraine Headache Frequency in an Adult Population

Design
Retrospektive Kohorte
Sample
n = 121 Pat.
Key finding

Migraine headache frequency decreased significantly from 10,4 to 4,6 headaches per month (p<0,0001); 39,7% of patients reported positive effects, 11,6% negative effects.

Summary

Retrospective cohort study on medical cannabis in migraine (n=121 adults, Colorado 2010–2014). Migraine frequency decreased from 10,4 to 4,6 attacks/month (p<0,0001). Positive effects in 48 patients (39,7 %): migraine prophylaxis with frequency reduction (24 patients, 19,8 %) and attack termination (14 patients, 11,6 %). Inhaled forms frequently used for acute treatment. Negative effects in 14 patients (11,6 %), mainly somnolence and dosing difficulties with edibles.

DOI 10.1002/phar.1673 ↗
C
Sample size ★★★★★
Blinding —
Effect size —
Citations / year ★★★★★
Mosek et al. ·2014 ·The Journal of Headache and Pain
2 citations

EHMTI-0136. Medical cannabis in the treatment of treatment-resistant, chronic cluster headache. A retrospective report

Design
Retrospektive Kohorte
Sample
n = 82 Pat.
Summary

Retrospective cohort study on medical cannabis for chronic headache (n=82, median pain intensity 9/10). After 6 months, 94,6% (of 37 responders) reported improvement, 5,4% no change; discontinuation rate 4,8%.

DOI 10.1186/1129-2377-15-s1-c46 ↗

Narrative Reviews

Non-systematic overview and expert articles that contextualise the evidence base.

1
B
Sample size —
Blinding —
Effect size —
Citations / year ★★★★★
Baron et al. ·2018 ·Headache: The Journal of Head and Face Pain
243 citations

Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science

Design
Narrative Review
Sample
Narrative Review
Key finding

The paper describes analgesic and anti-inflammatory properties of cannabinoids and a possible synergistic effect of cannabis constituents in migraine and headache.

Summary

Narrative review on cannabis in migraine/headache/pain; discusses cannabinoids (THC, CBD), terpenes and flavonoids as well as entourage effects. No systematic data extraction or numerical outcomes reported; qualitative synthesis of accumulating evidence for analgesic and anti-inflammatory properties. Emphasizes need for research on migraine-specific efficacy data.

DOI 10.1111/head.13345 ↗

Ongoing and upcoming studies

Ongoing studies are still in the trial phase and are not evidence of efficacy or safety. The information serves educational purposes only.

1
  • NCT03972124 ClinicalTrials.gov Cannabis for the Prophylactic Treatment of Migraine Recruiting Phase 2 Start: 2026-04