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.