Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science
- 1 July 2018
- journal article
- research article
- Published by Wiley in Headache: The Journal of Head and Face Pain
- Vol. 58 (7), 1139-1186
- https://doi.org/10.1111/head.13345
Abstract
Background Comprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment of pain, including migraine and headache, with associated neurobiological mechanisms of pain modulation have been well described. Most of the existing literature reports on the cannabinoids Δ9‐tetrahydrocannabinol (THC) and cannabidiol (CBD), or cannabis in general. There are many cannabis strains that vary widely in the composition of cannabinoids, terpenes, flavonoids, and other compounds. These components work synergistically to produce wide variations in benefits, side effects, and strain characteristics. Knowledge of the individual medicinal properties of the cannabinoids, terpenes, and flavonoids is necessary to cross‐breed strains to obtain optimal standardized synergistic compositions. This will enable targeting individual symptoms and/or diseases, including migraine, headache, and pain. Objective Review the medical literature for the use of cannabis/cannabinoids in the treatment of migraine, headache, facial pain, and other chronic pain syndromes, and for supporting evidence of a potential role in combatting the opioid epidemic. Review the medical literature involving major and minor cannabinoids, primary and secondary terpenes, and flavonoids that underlie the synergistic entourage effects of cannabis. Summarize the individual medicinal benefits of these substances, including analgesic and anti‐inflammatory properties. Conclusion There is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain‐specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease‐targeted therapies.Keywords
This publication has 639 references indexed in Scilit:
- Antinociceptive Activity and Redox Profile of the Monoterpenes (+)-Camphene,p-Cymene, and Geranyl Acetate in Experimental ModelsISRN Toxicology, 2013
- Borneol, a Bicyclic Monoterpene Alcohol, Reduces Nociceptive Behavior and Inflammatory Response in MiceThe Scientific World Journal, 2013
- Antioxidant and Antimicrobial Properties of the Essential Oil and Extracts ofZanthoxylum alatumGrown in North-Western HimalayaThe Scientific World Journal, 2013
- Nabilone for the treatment of medication overuse headache: results of a preliminary double-blind, active-controlled, randomized trialThe Journal of Headache and Pain, 2012
- Cannabidiol in Humans—The Quest for Therapeutic TargetsPharmaceuticals, 2012
- β-Caryophyllene Inhibits Dextran Sulfate Sodium-Induced Colitis in Mice through CB2 Receptor Activation and PPARγ PathwayThe American Journal of Pathology, 2011
- Pharmacological evaluation of the natural constituent of Cannabis sativa, cannabichromene and its modulation by Δ9-tetrahydrocannabinolDrug and Alcohol Dependence, 2010
- Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasisBreast Cancer Research and Treatment, 2010
- Cannabinoid–opioid interactions during neuropathic pain and analgesiaCurrent Opinion in Pharmacology, 2010
- Low dose combination of morphine and Δ9-tetrahydrocannabinol circumvents antinociceptive tolerance and apparent desensitization of receptorsEuropean Journal of Pharmacology, 2007