4.1.2 Headaches
The research investigating the analgesic potential of LSD in headaches
has centered around both cluster-type headaches (CH) and migraine
headaches. Both conditions are generally chronic but episodic in nature,
making it important to distinguish between the specific use of
medications in their treatment, namely, the use of medications forprophylaxis or for acute abortive treatment.
Interestingly, medications commonly used to abort these types of
headaches (many from the ergotamine and triptan families), partially
share LSD’s (a lysergamide) mechanism of action as 5-HT receptor
modulators. The theoretical underpinnings of serotonin and possible role
of LSD and its analogs can play in the role of these types of headaches
have been considered since at least the 1960s. The use of
non-hallucinogenic LSD-analogs and other lysergamides have been studied
and used in the treatment of many of these headache
disorders.72 73 Despite mechanistic
plausibility, there have been no randomized clinical trials for LSD and
migraines. Other clinical studies investigating three single doses of an
LSD derivate (BOL-148, at a dose of 30 μg/kg/body weight) safely
improved CH cycles or significantly improved frequency/intensity of
episodes in four out of five patients.73 Other
qualitative studies with patients self-medicating with LSD reported
prophylactic and acute abortive benefits.74 Another
preliminary study suggests that micro-dosing, or using
sub-hallucinogenic dosages, of LSD may also be beneficial to prevent
headache episodes.75 In summary, the use of LSD for
headaches holds promise as a therapeutic option, but research in the
area is still in early stages.
Interviews with 53 patients living with CH who were using psilocybin or
LSD without medical supervision to treat the condition, have found that
seven of the eight participants who used LSD reported termination of
cluster periods, and four of those reported that the substance
significantly prolonged their periods of remission. 76Online survey studies including 496 participants from a specific CH
support group suggested that a single dose of LSD could prevent attacks,
shorten, or even abort cluster episodes, or induce
remission.77 Several participants reported using
small, sub-hallucinogenic doses, suggesting that a psychedelic
experience may not be an essential component of therapeutic efficacy.