title: Cluster attacks responsive to recreational cannabis and dronabinol.
abstract: Pharmacological preparations of cannabinoid compounds have a variety of therapeutic uses in medicine, including different pain syndromes, but have not been previously reported as beneficial for cluster headache. We present a patient with cluster headache who was refractory to multiple acute and preventive medications but successfully aborted his attacks with recreational marijuana use; subsequent use of dronabinol provided equally effective pain relief. The beneficial effect may be related to the high concentration of cannabinoid receptors in the hypothalamus, which has been implicated as a site of dysfunction in neuroimaging studies of patients with cluster headache.
authors.affiliation: Montefiore Headache Center, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Robbins
authors.forename: Sara
authors.initials: S
authors.lastname: Tarshish
authors.forename: Seymour
authors.initials: S
authors.lastname: Solomon
authors.forename: Brian M
authors.initials: BM
authors.lastname: Grosberg
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D002188:Cannabis / Q000737:chemistry*; D003027:Cluster Headache / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004087:Dihydroergotamine / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use; D013759:Dronabinol / Q000008:administration & dosage*; D004351:Drug Resistance / Q000502:physiology; D004359:Drug Therapy, Combination; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use; D008787:Metoclopramide / Q000627:therapeutic use; D000077236:Topiramate; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000077236:Topiramate; D005632:Fructose; D004087:Dihydroergotamine; D014635:Valproic Acid; D013759:Dronabinol; D004155:Diphenhydramine; D008550:Melatonin; D008787:Metoclopramide