Fitocanabinóides e migrânea: uma revisão integrativa
DOI:
https://doi.org/10.34117/bjdv9n2-062Keywords:
migrânea, enxaqueca, fitocanabinoides, canabinóides, canabidiol, neurologiaAbstract
Introdução:Nos últimos anos vários estudos mostram uma relação entre o sistema endocanabinóide e o processamento da dor. Levantando a discussão de a forma exógena, os fitocanabinóides serem utilizados para o controle de crises epilépticas, dor neuropática e recentemente sendo analisado para o tratamento das cefaleias primárias do tipo migranosa.Objetivo:Esta revisão visa rever os estudos existentes na literatura que utilizaram fitocanabinóides no tratamento da migrânea, e analisar seus resultados, avaliando a aplicabilidade dos fitocanabinóides no tratamento da migrânea.Método: Baseado na busca da literatura em banco de dados dos últimos vinte anos utilizando como descritores “endocanabinoides and migrânea”, “fitocanabinóides and migrânea” e “migrânea juvenil and canabidiol” encontramos 286 artigos dos quais apenas 23 preencheram o critério de inclusão.Resultados: Houve como resultado da seleção, 23 artigos, dos quais:4 estudos clínicos, 11 revisões de literatura e 8 análises em modelo animal.Conclusões: Embora seja um tema muito pertinente, não há na literatura disponível, número adequado de pesquisas para a avaliação clínica do uso da Cannabis medicinal na migrânea, embora os resultados em modelo animal e os dados de revisões mostrem evidências favoráveis ao uso, não é possível especular a dose, a segurança ou a eficácia do uso clínico, sendo necessárias mais pesquisas clínicas randomizadas em humanos.
References
Baron EP. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache. 2018 Jul;58(7):1139-1186. doi: 10.1111/head.13345. PMID: 30152161.
Greco R, Gasperi V, Sandrini G, Bagetta G, Nappi G, Maccarrone M, Tassorelli C. Alterations of the endocannabinoid system in an animal model of migraine: evaluation in cerebral areas of rat. Cephalalgia. 2010 Mar;30(3):296-302. doi: 10.1111/j.1468-2982.2009.01924.x. Epub 2010 Feb 1. PMID: 19515121.
Dux M, Deák É, Tassi N, Sántha P, Jancsó G. Endovanilloids are potential activators of the trigeminovascular nocisensor complex. J Headache Pain. 2016;17:53. doi: 10.1186/s10194-016-0644-7. Epub 2016 May 17. PMID: 27189587; PMCID: PMC4870586.
Grotenhermen F, Müller-Vahl K. The therapeutic potential of cannabis and cannabinoids. Dtsch Arztebl Int. 2012 Jul;109(29-30):495-501. doi: 10.3238/arztebl.2012.0495. Epub 2012 Jul 23. PMID: 23008748; PMCID: PMC3442177.
Speciali JG, Dach F. Temporomandibular dysfunction and headache disorder. Headache. 2015 Feb;55 Suppl 1:72-83. doi: 10.1111/head.12515. Epub 2015 Feb 3. PMID: 25644695.
Greco R, Demartini C, Zanaboni AM, Piomelli D, Tassorelli C. Endocannabinoid System and Migraine Pain: An Update. Front Neurosci. 2018 Mar 19;12:172. doi: 10.3389/fnins.2018.00172. PMID: 29615860; PMCID: PMC5867306.
Greco R, Demartini C, Zanaboni AM, Tumelero E, Icco R, Sances G, Allena M, Tassorelli C. Peripheral changes of endocannabinoid system components in episodic and chronic migraine patients: A pilot study. Cephalalgia. 2021 Feb;41(2):185-196. doi: 10.1177/0333102420949201. Epub 2020 Sep 23. PMID: 32967434.
Ramsden CE, Zamora D, Makriyannis A, Wood JT, Mann JD, Faurot KR, MacIntosh BA, Majchrzak-Hong SF, Gross JR, Courville AB, Davis JM, Hibbeln JR. Diet-induced changes in n-3- and n-6-derived endocannabinoids and reductions in headache pain and psychological distress. J Pain. 2015 Aug;16(8):707-16. doi: 10.1016/j.jpain.2015.04.007. Epub 2015 May 7. PMID: 25958314; PMCID: PMC4522350.
KOWACS, Fernando et al. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arquivos de Neuro-Psiquiatria [online]. 2019, v. 77, n. 7 [Accessed 25 September 2021] , pp. 509-520. Available from: <https://doi.org/10.1590/0004-282X20190078>. Epub 29 July 2019. ISSN 1678-4227. https://doi.org/10.1590/0004-282X20190078.
Kandasamy R, Dawson CT, Craft RM, Morgan MM. Anti-migraine effect of ∆9-tetrahydrocannabinol in the female rat. Eur J Pharmacol. 2018 Jan 5;818:271-277. doi: 10.1016/j.ejphar.2017.10.054. Epub 2017 Oct 28. PMID: 29111112; PMCID: PMC5742305.
Greco R, Mangione AS, Sandrini G, Maccarrone M, Nappi G, Tassorelli C. Effects of anandamide in migraine: data from an animal model. J Headache Pain. 2011 Apr;12(2):177-83. doi: 10.1007/s10194-010-0274-4. Epub 2011 Feb 18. PMID: 21331757; PMCID: PMC3072518.
Greco R, Gasperi V, Maccarrone M, Tassorelli C. The endocannabinoid system and migraine. Exp Neurol. 2010 Jul;224(1):85-91. doi: 10.1016/j.expneurol.2010.03.029. Epub 2010 Mar 29. PMID: 20353780.
Greco R, Mangione AS, Sandrini G, Nappi G, Tassorelli C. Activation of CB2 receptors as a potential therapeutic target for migraine: evaluation in an animal model. J Headache Pain. 2014 Mar 17;15(1):14. doi: 10.1186/1129-2377-15-14. PMID: 24636539; PMCID: PMC3995520.
Nozaki C, Markert A, Zimmer A. Inhibition of FAAH reduces nitroglycerin-induced migraine-like pain and trigeminal neuronal hyperactivity in mice. Eur Neuropsychopharmacol. 2015 Aug;25(8):1388-96. doi: 10.1016/j.euroneuro.2015.04.001. Epub 2015 Apr 13. Erratum in: Eur Neuropsychopharmacol. 2015 Nov;25(11):2186. PMID: 25910421.
Akerman S, Kaube H, Goadsby PJ. Anandamide is able to inhibit trigeminal neurons using an in vivo model of trigeminovascular-mediated nociception. J Pharmacol Exp Ther. 2004 Apr;309(1):56-63. doi: 10.1124/jpet.103.059808. Epub 2004 Jan 12. PMID: 14718591.
Nagy-Grócz G, Tar L, Bohár Z, Fejes-Szabó A, Laborc KF, Spekker E, Vécsei L, Párdutz Á. The modulatory effect of anandamide on nitroglycerin-induced sensitization in the trigeminal system of the rat. Cephalalgia. 2016 Aug;36(9):849-61. doi: 10.1177/0333102415613766. Epub 2015 Oct 28. PMID: 26512068.
Baron EP. Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been …. Headache. 2015 Jun;55(6):885-916. doi: 10.1111/head.12570. Epub 2015 May 25. PMID: 26015168.
Russo EB. Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinol Lett. 2004 Feb-Apr;25(1-2):31-9. PMID: 15159679.
oyaji S, Merkow J, Elman RNM, Kaye AD, Yong RJ, Urman RD. The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence. Curr Pain Headache Rep. 2020 Jan 24;24(2):4. doi: 10.1007/s11916-020-0835-4. PMID: 31980957.
Kim PS, Fishman MA. Cannabis for Pain and Headaches: Primer. Curr Pain Headache Rep. 2017 Apr;21(4):19. doi: 10.1007/s11916-017-0619-7. PMID: 28281107.
Mechtler LL, Gengo FM, Bargnes VH. Cannabis and Migraine: It's Complicated. Curr Pain Headache Rep. 2021 Feb 25;25(3):16. doi: 10.1007/s11916-020-00931-2. PMID: 33630181.
Volfe Z, Dvilansky A, Nathan I. Cannabinoids block release of serotonin from platelets induced by plasma from migraine patients. Int J Clin Pharmacol Res. 1985;5(4):243-6. PMID: 2997048.
Barakji JA, Korang SK, Feinberg J, Maagard M, Gluud C, Mathiesen O, Jakobsen JC. Cannabinoids versus placebo or no intervention for pain: protocol for a systematic review with meta-analysis and trial sequential analysis. BMJ Open. 2019 Oct 31;9(10):e031574. doi: 10.1136/bmjopen-2019-031574. PMID: 31676655; PMCID: PMC6830650.
Aviram J, Vysotski Y, Berman P, Lewitus GM, Eisenberg E, Meiri D. Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study. Brain Sci. 2020 Jun 9;10(6):360. doi: 10.3390/brainsci10060360. PMID: 32526965; PMCID: PMC7348860.
Lo Castro F, Baraldi C, Pellesi L, Guerzoni S. Clinical Evidence of Cannabinoids in Migraine: A Narrative Review. J Clin Med. 2022 Mar 8;11(6):1479. doi: 10.3390/jcm11061479. PMID: 35329806; PMCID: PMC8949974.
Kalaba M, Ware MA. Cannabinoid Profiles in Medical Cannabis Users: Effects of Age, Gender, Symptoms, and Duration of Use. Cannabis Cannabinoid Res. 2021 May 17. doi: 10.1089/can.2020.0120. Epub ahead of print. PMID: 33999649.
Melinyshyn AN, Amoozegar F. Cannabinoid Use in a Tertiary Headache Clinic: A Cross-Sectional Survey. Can J Neurol Sci. 2021 Sep 13:1-10. doi: 10.1017/cjn.2021.215. Epub ahead of print. PMID: 34511153.
Baraldi C, Lo Castro F, Negro A, Ferrari A, Cainazzo MM, Pani L, Guerzoni S. Oral Cannabinoid Preparations for the Treatment of Chronic Migraine: A Retrospective Study. Pain Med. 2022 Feb 1;23(2):396-402. doi: 10.1093/pm/pnab245. PMID: 34347088.

