Scientists are now exploring a new way to get rid of cluster headaches. The findings of the first randomized, double-blind, placebo-controlled research on psilocybin’s effects on cluster headache have been published in the scientific journal Headache. The preliminary study gives useful information for future, larger and more comprehensive studies.
Cluster headache is a neurological disorder that causes excruciatingly painful headaches similar to severe migraines and affects approximately 0.1% of the population. It is distinguished by abrupt, acute, and excruciating pain that occurs in cycles or “clusters.”
Many doctors consider cluster headaches to be one of the most excruciating disorders in existence due to the intensity of the pain they inflict.
For years, anecdotal evidence has circulated that psilocybin, the hallucinogenic ingredient contained in “magic mushrooms,” can help relieve cluster headaches. Yet, there is little scientific data to support these assertions.
“For decades, cluster headache patients have self-managed their disease with psilocybin-containing mushrooms and other similar substances,” said lead researcher Emmanuelle A. D. Schindler, an assistant professor of neurology at Yale School of Medicine and the medical director of the Headache Center of Excellence at VA Connecticut Healthcare System.
“Importantly, patients report long-lasting improvements following limited medication doses. I intended to convey this knowledge to the medical and scientific sectors in their own language, specifically through automobiles.”
The researchers recruited a group of 16 individuals (aged 21-65 years) who suffered cluster headaches. However, we were otherwise free of other significant medical or psychological disorders.
Subjects were randomly assigned to receive three doses of psilocybin (0.143 mg/kg) or a placebo in sessions five days apart. The study used an advanced blinding process. This is such that both the subjects and the research personnel were unaware of the drug dose.
What Participants in the Study did
Participants kept headache diaries, beginning two weeks before and ending eight weeks after the first session.
Individuals who received psilocybin reported fewer cluster headache symptoms, however, this difference was not statistically significant when compared to placebo.
“There is evidence for therapeutic effects of psilocybin in cluster headache in this little preliminary trial,” Schindler said.
“Although the 30% reduction in the number of headache attacks per week was not statistically significant, it was clear that some patients in the research responded while others did not. Consequently, while the average reduction in weekly attacks was 30%, the average reduction in those who replied was closer to 75%.”
The lack of statistical significance could be attributed to the exploratory nature of the study and the small sample size. Cluster headaches’ cyclical and unpredictable nature can also make it difficult to detect an effect.
“The sample size was rather small (only 14 in the final analysis), the treatment regimen (3 doses, 5 days apart each) was only administered once (results of a repeat round will be reported this year), and reactions were variable (some responded and some plainly did not),” Schindler explained.
“These considerations would have an impact on the statistical significance of any research on preventative cluster headache therapy.”
Despite the lack of statistical significance, the preliminary findings can be utilized to guide bigger and more conclusive investigations. “There is still a lot of work to be done,” Schindler added.
A New Way to Get Rid of Cluster Headaches
“This research barely scrapes the surface. We need larger studies with hundreds of patients and longer-term studies (years). Also, protocols that allow for dose regimen modifications based on how patients respond (as is common in headache care).”
Surprisingly, the severity of acute psychedelic effects, such as feelings of oneness with the cosmos and changes in visual perception, was unrelated to changes in cluster attack frequency.
“Our study found no association between the intensity of the psychedelic experience on the days the medication was delivered and the reduction in weekly headache bouts over time,” Schindler added. “This is in contrast to research on mental health issues, where there appears to be a link.”
“Since headache ailments are not mental health disorders, the lack of a link makes logical sense.” Because headache disorders are not psychiatric diseases, the protocol in my cluster headache and migraine studies does not include some of the treatments used in mental health studies, such as psychotherapy.”
Cluster headaches are thought to be caused by anomalies in the hypothalamus, a portion of the brain that governs the body’s internal clock and controls numerous biological systems such as sleep and the autonomic nervous system.
Although psilocybin has been shown to reduce cerebral blood flow to the hypothalamus, it is unknown whether this affects headache sensations.
“It’s critical to acknowledge that the way psychedelics may be used as treatments may vary depending on the disease,” Schindler added. “It’s also worth noting that psychedelics have chemistry and pharmacology in common with headache medications.”
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“In reality, when Albert Hofmann invented LSD in 1938, he was looking for a medicine with vaso- and bronchospastic qualities, something that could be employed in migraine. Methysergide, a chemical derived from the LSD molecule, was a highly efficient headache reliever.”
“Methysergide was taken on a regular basis to prevent headaches. This resulted in adverse effects and the medicine being withdrawn from the market. This experience teaches us how to use psychedelics in the treatment of headaches and other conditions.”
Things to Keep in Mind
Cluster headaches are characterized by extreme pain around the eye, temple, or forehead. It often occurs on one side of the head. The precise etiology of cluster headaches is unknown. However, it is thought to be a combination of genetic, environmental, and neurovascular factors.
Cluster headaches are thought to be caused by problems in the hypothalamus. This is a tiny region of the brain that regulates a range of physiological activities. Activities such as sleep-wake cycles, body temperature, and circadian rhythms. Disruptions in the hypothalamus are considered to produce abnormalities in blood flow. Also, it produces inflammation in the trigeminal nerve, which is responsible for sensation in the face and head.
Changes in serotonin levels, which can impact pain perception and blood vessel constriction, as well as environmental triggers such as alcohol, smoke, and certain meals, may also contribute to the development of cluster headaches.
Overall, the precise mechanisms underlying cluster headaches are still being researched. Also, experts are looking at potential treatments and preventative measures for this debilitating ailment.