Headache Treatment – Alternative or Illicit?




Headache disorders can be painful and debilitating conditions. Ranging from infrequent tension-type headaches to cluster headaches to migraines, headaches affect nearly every individual at one time or another. Pain – particularly of the neck and back – accompany many headaches. Traditional pharmacological treatment begins with acetaminophen (Tylenol), but this is not effective for all headache sufferers. More potent pain-killers are used in a step-wise manner to treat pain associated with headache, and preventive and abortive treatments are available and effective for certain types of headache. The most alarming headache treatment option to emerge is the use of lysergic acid diethylamide (LSD) and psilocybin (a hallucinogen derived from mushrooms).

The acknowledgement that hallucinogenic drugs might have a benefit in headache treatment first appeared in the medical literature in the 1960’s and 1970’s. Of course, the stigma associated with drug use at that time was not what it is today, and the dangers associated with drug use were not as well-defined. Now, more than 50 years after Timothy Leary was expelled from Harvard, arguably for supporting the use of illegal drugs, LSD is returning to the school. A Harvard professor is now self-funding research to prove that hallucinogenic drugs are effective headache treatment.

In 2006, an analysis of people who took LSD and/or psilocybin to treat cluster headaches was published by Harvard researchers. The report included results from interviews with 53 patients who had used the psychedelic agents to self-treat cluster headaches. Remarkably, a majority of patients reported benefits of the drugs, including an end to headaches and an extended remission period. The data is limited owing to a small sample size and recall bias; the study was not controlled or randomized.

The use of treatments other than traditional pharmacological management is increasing, owing to general dissatisfaction with traditional medicine, the risk of side effects of traditional headache treatments, and a desire for patient autonomy in healthcare. However, herbal supplements or massage techniques to treat headaches are a far cry from hallucinogenic drugs. The scientist leading the research into hallucinogens claims that his work has produced a non-hallucinogenic derivative of LSD. He is investigating the effectiveness of the compound and is interested in seeking FDA approval for the agent. So far, no major pharmaceutical companies are interested in joining forces with him.

Throughout the history of pharmacy and medicine, there are examples of treatments being discovered in unlikely places, but LSD as a therapeutic agent seems quite extreme. Current treatments are far from perfect, and, admittedly, are not effective for every person or every type of headache. But, LSD and psilocybin are illicit drugs, classified as Schedule I drugs by the FDA, having no recognized medical use and a high potential for abuse. Though therapeutic doses might be at sub-hallucinogen levels, there is no evidence regarding the safety or abuse related to these experimental compounds.

Headaches are not altogether understood. Therefore, treatment options are not well-defined. Headaches can be caused by a variety of conditions – medical, physical, or emotional — and treatment options vary more than the causes of headaches. Research concerning the best possible headache treatment is far from definitive, as is the role of hallucinogenic drugs in traditional medicine. Physicians and patients should make advised and cautious decisions about all treatment modalities. Larger-scale randomized, controlled trials are needed before patients should be advised to take a trip to treat a headache.

References

Ahn CB, Lee SJ, Lee JC, Fossion JP, & Sant’ana A (2011). A Clinical Pilot Study Comparing Traditional Acupuncture to Combined Acupuncture for Treating Headache, Trigeminal Neuralgia and Retro-auricular Pain in Facial Palsy. Journal of acupuncture and meridian studies, 4 (1), 29-43 PMID: 21440878

Biondi DM (2005). Physical treatments for headache: a structured review. Headache, 45 (6), 738-46 PMID: 15953306

Biondi DM (2005). Noninvasive treatments for headache. Expert review of neurotherapeutics, 5 (3), 355-62 PMID: 15938668

Leone M, Franzini A, Cecchini AP, Mea E, Broggi G, & Bussone G (2009). Cluster headache: pharmacological treatment and neurostimulation. Nature clinical practice. Neurology, 5 (3), 153-62 PMID: 19262591

Sewell RA (2009). Response of cluster headache to kudzu. Headache, 49 (1), 98-105 PMID: 19125878

Sewell RA, Halpern JH, & Pope HG Jr (2006). Response of cluster headache to psilocybin and LSD. Neurology, 66 (12), 1920-2 PMID: 16801660

Söderberg E, Carlsson J, & Stener-Victorin E (2006). Chronic tension-type headache treated with acupuncture, physical training and relaxation training. Between-group differences. Cephalalgia : an international journal of headache, 26 (11), 1320-9 PMID: 17059439

Söderberg EI, Carlsson JY, Stener-Victorin E, & Dahlöf C (2011). Subjective Well-being in Patients With Chronic Tension-type Headache: Effect of Acupuncture, Physical Training, and Relaxation Training. The Clinical journal of pain PMID: 21317776

Sun-Edelstein C, & Mauskop A (2011). Alternative headache treatments: nutraceuticals, behavioral and physical treatments. Headache, 51 (3), 469-83 PMID: 21352222

  • John

    This is a poor article from a scientific perspective. Pure opinion & claptrap, with adjectives like “alarming” and “extreme” exemplifying a gross bias on the part of the author with regards to the subject matter. Indicating that the FDA’s classification of a compound as a schedule 1 drug somehow negates any potential medicinal value is short sighted at best. The act of scheduling is a political act and greatly limits research opportunities, in turn greatly diminishing potential discovery of therapeutic benefit. The author’s background would indicate that she should be aware of this. Highly disappointing.

    • Jordache

      “Current treatments are far from perfect, and, admittedly, are not effective for every person or every type of headache. But, LSD and psilocybin are illicit drugs, classified as Schedule I drugs by the FDA, having no recognized medical use and a high potential for abuse”

      According to the author’s own article they do have a potential use: the treatment of headaches.

      Just because something has the potential for high abuse does not mean that it will be abused. Look at the legal consumption of alcohol; a known carcinogen, known to be addictive, known to cause cirrhosis and malnutrition but yet its sold in corner stores.

      The dose makes the poison and someone with a PharmD should know this more than anyone.

  • The non-hallucinogenic 2-bromo-lysergic acid diethylamide (also called 2-Bromo-LSD or BOL-148) may be an alternative treatment for cluster headache, see Karst M, Halpern JH, Bernateck M, Passie T (September 2010). “The non-hallucinogen 2-bromo-lysergic acid diethylamide as preventative treatment for cluster headache: an open, non-randomized case series”. Cephalalgia 30 (9): 1140–4.
    http://cep.sagepub.com/content/30/9/1140

  • Never in my wildest dreams would I have thought to use LSD or other hallucinogenic drugs for the treatment of headaches. What can the scientific community be thinking when they suggest this when there are so many other options such as acupressure or massage treatments available. These drugs make aspirin look harmless when we know that even they have side effects.

    • anthony

      There are no side effects, just effects. Some are desirable some are not, but but all the effects are inter-related, like a rubic’s cube. I also would not think hallucinogens would be desirable during a migraine attack, but that is precisely why we have science. So we can figure out solutions to problems that are not obvious. The scientific community should not have to bother wondering whether what they are doing is popular or not, there is enough people in the world who have those petty worries, they are to be concerned with results. And really do we need to worry about people abusing lsd and mushrooms while crippled by a migraine. If this does not work I’m sure it would be a horrible experience.

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  • Aaron

    Firstly, I would point out the that research into the use of LSD and psilocybin to treat headaches has been into cluster headaches, not headaches in general.
    Cluster headaches have been said to be the most painful condition one can suffer from, women say the pain is worth than giving birth.

    Now, according to a study conducted by David Nutt for the Lancet, mushrooms i.e. psilocybin cause the least harm of all the major illicit drugs of (ab)use both on an individual and societal level.
    LSD follows close in front.

    So, if these drugs have been shown to be of little potential harm, and have been shown to be a potential treatment for one the most debilitating conditions to suffer from, it would seem clear that these compounds should have no stigma attached. The context of drug use is an important factor to consider also.

  • pamela

    I have to admit this is a very shocking article but to me I would do just about anything to get rid of my migranes and my tension headaches. I have suffered from them now for 17 years and they are horrid. The headaches rule my life at times and I miss out on so much that life has to offer such as spending time with my kids, work and even being sociable. I have tried all types of medications and even chiropractic care but none of them have helped. I am not sure if I would try this but honestly who knows where the research may lead. We all know that cures and answers can often be found in strange places when we least expect them so I say as long as it is in a controlled setting we should explore this option.

  • Kim

    I have suffered with cluster headaches for 25 yrs of my life they are the most crippling painful thing i have ever experienced. Wanda i would like you to feel the pain for a week and see what you would be doing to be painfree. I have heard about the mushrooms and how they work. Modern medicines have terrible side affects and long term damages. I would rather have a natural then a chemical inbalance. trying the mushrooms is going to be worth trying.

  • Nicole

    I have disabling migraines that sometimes occur on a regular basis. Aspirin is not an option because I have a blood clotting disorder and it could kill me if I took it every day. (by the way. It is NOT safe; just look at how many people it kills every year.) Other than low doses of psilocybin that have absolutely no side effects or psychedelic effects, my only option is to take pharmaceuticals that may burn holes in my stomach lining or destroy my liver someday. I prefer natural medicine over toxic cheicals anyday.

  • Turk

    “Throughout the history of pharmacy and medicine, there are examples of treatments being discovered in unlikely places, but LSD as a therapeutic agent seems quite extreme. ”

    It isn’t as extreme as the author suggests. LSD was an interesting by-product of research into medically useful derivatives of ergotamine, a toxic substance produced by the fungus C. Paspali. As its tartrate salt, ergotamine is used to treat migraines itself. It is sold under the brandnames Cafergot and Ergomar.

    Although LSD was never marketed as a traditional drug, methysergide, a molecule virtually identical to LSD, was sold under the brandname “Sansert” for migraine prophylaxis. Methysergide also has hallucinogenic effects.

    The newer family of migraine drugs, known as triptans (e.g., Imitrex) are structurally similar to psilocybin, the compound that gives “magic mushrooms” their magic.

    In short, what drug companies have done is taken known substances with high safety margins, created more toxic derivatives, taken away the fun, and sold them for $400 for a pack of 10 doses as abortive medications (in the case of Axert).

    $400 can buy 30-40 doses of psilocybin mushrooms for migraines. Given that a single dose can offer months of relief from cluster headaches, that’s enough to last a decade. That gives them their life back. That’s what’s important.

  • Jessica

    As you said – the biggest problem is that headaches aren’t altogether understood and treatment options aren’t well defined.

  • Some headache can be caused by worms. This happens when worms from the intestine migrate from the stomach to the brain. This result from eating undercooked meat, drinking of water containing the eggs of tapeworm.
    SYMPTOMS
    The symptoms are general weakness of the body, too much sleep, anxiety, nervo
    usness, depression, forgetfullness, and some cases of frequent urination.
    TREATMENT
    stong worm expeller (deworm medicine) with reapeated dosage. Deworm medcine like prazilquantel and albendazole. Prazilquantel is mainly better with reapeated dosage.

  • Matt

    Once migraine or tension headaches are present, preventative treatment options aren’t feasible options. Other medications are available to relieve the pain caused by tension headaches. Analgesics are often the first type of tension headache treatment prescribed. But of course, every pain has its own equivalent treatment so better ask for doctor to proper prescription.

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  • Diogenes de Sinope

    I didn’t think it was possible to state an unfounded opinion twelve times in six paragraphs without it being labeled an opinion piece.

    I notice that you tried to make this look professional by including a lot of sources, but unfortunately none of them support your extended digressions about how dangerous hallucinogens are.

    The danger of a drug is typically measured by its therapeutic index (ratio of its effective dose to its toxic dose). Good old harmless over-the-counter acetaminophen (Tylenol) has a therapeutic index of 1/30. Lithium was a terrifying 1/3, but they phased it out in favor of stuff like fluoxetine (Prozac), which is 1/100 (Gable 2004).

    The therapeutic index of LSD actually isn’t very well established, because nobody has ever overdosed on it. The normal dose is somewhere between 100 and 200 micrograms, which means a single gram contains five to ten thousand doses. In the wild-arse sixties, some incredibly brazen people in the higher circles of the distribution network (with virtually unlimited amounts of LSD) took “thumbprints”, which were literally the amount of crystalline powder that fit on a person’s thumb. This was anywhere from 10 to 40 milligrams, but still nobody died from it. But heck, let’s say they all did – forty milligrams is still four hundred doses, which would puts its therapeutic index at 1/400. I find it quite hard to believe that someone could ingest four hundred doses of any drug without realizing what they’re doing, unless they walk into a synthesis lab and start consuming things at random.

    If you had bothered to read the studies regarding the use of ergot derivatives in cluster headache treatment, you would know that this effect is either realized at sub-hallucinogenic doses or realized through non-hallucinogenic substances (Karst 2010). Nobody is “tripping”.

    Furthermore, there’s nothing “illicit” going on. Schedule I substances are not simply banned from ever existing. The DEA issues research licenses. The fact that they “have no accepted medical use” is a canard, since the very issue at hand is medical research to develop new uses. Your logic is circular.

    It’s almost as if you didn’t bother to do the proper research before slapping together a semi-coherent article to stir up a moral panic about something that really wasn’t a big deal at all…

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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