Migraine and Cluster Headaches

Migraine and Cluster Headaches

Headache is a distressing and prevalent condition characterized by pain in the head or at the top of the neck. The pain is typically described as pressure, throbbing, or a sharp, stabbing sensation, and its severity can range from mild to intense. The duration of headaches varies, with some lasting just a few minutes and others persist for a few days. The Timing and pain intensity of headaches are specific to their respective types. Among all types of headaches, migraine and cluster headaches are current.

Migraine

Currently, 10-20% of people are grabbling with migraines a condition that significantly diminishes their quality of life and greatly hampers their functionality. The World Health Organization (WHO) recognizes migraine as one of the most prominent debilitating diseases. Migraine symptoms include sensitivity to light, sound, smell, or touch. Although the exact cause of migraine attacks is unknown, genetics and environmental factors are believed to play a significant role in its occurrence. The diagnosis of this condition relies on clinical examination, CT scan, MRI, and electroencephalography.

Migraine Symptoms

Migraine symptoms may persist 1-2 days prior to the onset of the actual headache, which is known as the Prodromal phase. During this phase, various symptoms can manifest, including food cravings, depression, fatigue or lack of energy, frequent yawning, ADHD, irritability, and neck stiffness. These Symptoms may be observed in certain patients before or during the migraine. Each symptom typically lasts for a few minutes to 1 hour.

Migraine attacks usually have throbbing pain and appear on one side of the head. Sensitivity to light, sound, and smell, nausea, and vomiting are likely to happen hours or a day before the attack.

Migraine and Cluster Headaches

Migraine Prevalence

Migraine is one of the most prevalent headaches among the chronic ones, affecting one billion people worldwide. Approximately half to 3/4 of adults between the ages of 18-65 have experienced headaches and 30% of this population is diagnosed with migraine. These headaches impact 3% of adults and last about 15 days, yet 2/3 of the patients either don’t seek medical attention or discontinue their appointments. As a result, this condition often remains undiagnosed or inadequately treated.

This condition is more prevalent among women aged 30-40, while boys under the age of 12 are also susceptible to it. Migraine often coexists with other disorders including depression, anxiety, sleep disorders, and epilepsy.

Migraine and Cluster Headaches

Cluster Headache

Cluster headaches are widely regarded as one of the most excruciating types of headaches. These intense headaches typically last between 15 minutes to 3 hours with an average duration of 45-90 minutes. Cluster headache attacks tend to occur at a specific time of the day, and it is more likely to happen at night. Their frequency of occurrence can vary, ranging from every other day to as frequent as 8 times a day.

Cluster headaches can be classified into two categories: episodic and chronic with the episodic type being more common and affecting 80-90% of the patients.

Patients with chronic headaches experience frequent attacks that persist for more than a day without any sign of recuperation, while in some cases, recovery occurs within a span of less than 3 months. In these situations, preventive medication is ineffective.

Attacks in chronic headaches occur sporadically taking place over weeks or even months. In contrast, Patients with episodic headaches may observe a pattern in their frequency of occurrence with a higher likelihood during the spring and spring and fall seasons.

Symptoms of Cluster Headaches

Cluster headaches are known for their excruciating pain and a range of associated symptoms. These symptoms include miosis (constricted pupils), eye discomfort or epiphora, nasal congestion, and discharge, swelling around the eyes, throat inflammation, and facial pain. The international classification of headache disorders is the primary diagnostic criterion, relying on medical reports and symptoms applicable to all headache types. For a diagnosis of episodic cluster headaches, this criterion requires a minimum of two periods of unilateral attacks lasting consistently between 7 days to 1 year or remission periods lasting less than 3 months.

The Difference Between Migraine and Cluster Headache

Cluster headaches are among the most severe types of headaches, and certain features set them apart from migraines. Restlessness and agitation are notable during cluster headache attacks, distinguishing them from migraines. Migraine patients typically prefer to remain motionless, while those with cluster headaches often exhibit movement to alleviate the pain through applied pressure. Typically, after cluster headache attacks subside, patients experience complete relief from pain.

Migraine and Cluster Headaches

Cluster Headaches Prevalence

Cluster headaches can affect individuals of all ages globally, with a higher incidence in men compared to women (with a ratio of 1 to 3). The onset of cluster headaches can occur between the ages of 10 to 68, with the average age consistent across genders, usually manifesting during the third decade of life. Unfortunately, in some societies, cluster headaches may go undiagnosed, leading to inadequate treatment. Patients may also experience potential comorbidities such as depression, sleep disorders, and lifestyle factors like smoking, alcoholism, and drug abuse.

Impressive Factors for Headache Occurrence

Certain habits and factors, such as smoking, head trauma, a family history of headaches, alcoholism, and exposure to strong odors like perfumes and paint, are relevant to both cluster headaches and migraines. Stimulants can trigger intense pain in both headache types. People with first or second-degree relatives affected by cluster headaches are at a higher risk. Additionally, factors like drug history, oral contraceptive pills (OCPs), non-steroidal anti-inflammatory drugs (NSAIDs), and the medical and psychological history of patients can contribute to these headaches.

Advancements in Treating Different Headache Types

Over the last two decades, our understanding of the pathophysiology of cluster headaches and migraines has significantly improved, based on the recent preclinical and clinical studies, genetics, and neuroimaging research.

Psilocybin and its Impact on Headaches

Psilocybin, a psychedelic compound and it is found in some fungi commonly known as magic mushrooms, has exhibited significant potential in the treatment of migraine and cluster headaches. This compound has demonstrated the ability to reduce the severity of pain and functional disturbances associated with these debilitating conditions. Psilocybin achieves these effects by stimulating excitatory synapses and modulating serotonergic receptors, particularly the 5-HT2A receptor. This modulation effectively prevents headache attacks and alleviates other associated symptoms.

Psilocybin and its Impact on Headaches

In recent studies, the consumption of psilocybin by migraine patients has resulted in a remarkable 50% reduction in the frequency of attacks, with effects lasting for at least two weeks.

Numerous clinical trials have explored the impact of psilocybin on cluster headaches and migraines. A study published in the Neurology journal in 2006 revealed that 2-3 doses of psilocybin reduced the intensity of pain in cluster headaches by up to 91%. Similarly, a double-blind study published in Neurotherapeutics in 2021 involved adults with migraines who were administered a placebo and psilocybin at a dosage of 0.143 milligrams per kilogram.

A study featured in the HEADACHE journal in 2022 demonstrated that psilocybin mushrooms effectively alleviate cluster headaches and reduce the frequency of attacks. The study underscored the positive effects of psilocybin consumption, particularly when used in conjunction with a placebo, in the treatment of chronic cluster headaches.

These treatments were provided in two sessions, spaced two weeks apart. The results, observed after two weeks, indicated that psilocybin consumption led to a greater reduction in attacks compared to the placebo. These findings highlighted the sustained and long-lasting benefits of psilocybin treatment in migraine patients.

Migraine and Cluster Headaches

 

Dr. Emmanuelle Schindler, a neurologist at the Yale School of Medicine, reported significant and enduring improvements in patients with headache disorders following the administration of one or multiple doses of psilocybin. In a double-blind study involving patients with chronic migraines, participants were initially given a placebo for two weeks, followed by a low-dosage of psilocybin. Throughout this period, participants tracked their symptoms. The results revealed a substantial reduction in the frequency of migraine attacks following psilocybin consumption. Moreover, psilocybin significantly reduced pain intensity and functional disturbances. Dr. Schindler’s conclusion highlighted the distinct and valuable role of psilocybin in comparison to existing treatments, emphasizing its lasting effects on migraine relief, a benefit unmatched by current treatment options. These findings align with an earlier study by Dr. Schindler and her colleagues, published in 2015, demonstrating the efficacy of psilocybin mushrooms in preventing and treating cluster headache disorders, surpassing current treatments in effectiveness.

Conclusion

Research exploring the therapeutic potential of psilocybin in mitigating cluster headaches and migraines has unveiled promising outcomes. The administration of either one or two doses of psilocybin has proven notable reductions in headache intensity and duration, along with sustained improvements among participants in diverse studies.

The precise mechanism of action of psilocybin, its impact at varying dosage levels, and its efficacy in reducing the frequency and number of headache attacks, particularly eventually, are still subjects of ongoing investigation by researchers. To show the safety and effectiveness of this treatment approach, further research, including large-scale clinical trials, is imperative. Moreover, understanding the enduring effects and optimal dosages of psilocybin for headache management necessitates additional scrutiny.

Migraine and cluster headaches are persistent, chronic conditions. Consequently, identifying safe and effective dosages and treatment regimens for their long-term management is crucial. Nevertheless, these findings kindle hope for individuals grappling with cluster headaches and migraines, particularly those who have not found relief through conventional therapies.