Migraines and vaporized cannabis flower: a placebo-controlled, randomized trial

This seems to be the first randomized, double-blind, placebo-controlled, crossover trial of cannabinoid medicine use by adults with chronic migraines. The results were presented at the 2024 Annual Meeting of American Academy of Neurology on April 16, 2024.

71 migraine patients tested up to 4 different types of cannabis flower, each with a different THC/CBD ratio. The average age was 41 and they were mostly female (83%).

They inhaled vaporized flower only when experiencing a migraine headache event. In total they collected data on 234 separate migraine attacks.

The 4 different cannabis flower chemotypes that were tested:

  1. 6% THC
  2. 11% CBD
  3. 6% THC / 11% CBD mixture (approximately 1:2 ratio)
  4. Placebo flower


The THC/CBD mix (~1:2 ratio) was superior at reducing pain and the most bothersome symptom (MBS) when compared to the THC-only, CBD-only, and the placebo flower. 

Key results show significant reductions in symptoms using the 6% THC / 11% CBD flower versus placebo:

pain relief (67.2% vs 46.6%, p=0.016) at 2 hours

pain freedom (34.5% vs. 15.5%, p=0.017) at 2 hours, sustained pain freedom at 24 hours

MBS freedom (60.3% vs. 34.5%, p=0.005) at 2 hours, sustained MBS freedom at 24 and 48 hours


The THC-only flower and the CBD-only flower did not show as promising results:

THC only was superior to placebo at achieving pain relief  (68.9% vs. 46.6%, p=0.008), but not pain freedom or MBS freedom at 2 hours

CBD only was not superior to placebo for any outcomes at 2 hours


There were no serious adverse events recorded. The full article is not yet available publicly, and the abstract does not mention dosage. However, during the presentation, an author (Nathaniel Marc Schuster, MD) stated, "4 puffs of vaporized THC-CBD mix were efficacious for acute migraine treatment".

The authors concluded:

Acute migraine treatment with vaporized cannabis flower containing 6% THC/11% CBD was efficacious at 2 hours post-treatment with sustained pain freedom at 24 hours and sustained MBS freedom at 24 and 48 hours.


The article abstract is here at the American Academy of Neurology publications.



Abstract S22.010, Advances in Migraine and Therapeutics presented  April 16 at the American Academy of Neurology (AAN) 2024 annual meeting.