This qualitative interview study (n=53) assessed the efficacy of psilocybin and LSD to treat cluster headaches and found that a single dose was often sufficient to terminate a cluster period and that subhallucinogenic doses were also often reported to be effective treatments.

Abstract

“Introduction: Cluster headache, often considered the most painful of all types of headache,1 affects predominantly men (0.4% vs 0.08% of women) and typically begins after age 20 years. No medications are known to terminate cluster periods or extend remission periods. The effects of the ergot alkaloid derivative lysergic acid diethylamide (LSD) and the related indolalkylamine psilocybin on cluster headache have not previously been described and may include such properties.

Methods: The authors interviewed 53 cluster headache patients who had used psilocybin or lysergic acid diethylamide (LSD) to treat their condition.

Results: Twenty-two of 26 psilocybin users reported that psilocybin aborted attacks; 25 of 48 psilocybin users and 7 of 8 LSD users reported cluster period termination; 18 of 19 psilocybin users and 4 of 5 LSD users reported remission period extension.

Discussion: Research on the effects of psilocybin and LSD on cluster headache may be warranted.”

Authors: R. Andrew Sewell, John H. Halpern & Harrison G. Pop

Summary

Neurology (2006) 66:1920 psilocybin and LSD in cluster headache. Published continuously since 1951, it is now a weekly with 48 issues per year.

Cluster headache, often considered the most painful of all types of headache, affects predominantly men and typically begins after age 20 years. Oxygen and sumatriptan are the mainstays of acute abortive treatment, whereas verapamil, lithium, corticosteroids, and other neuromodulators can suppress attacks during cluster periods.

A man with episodic cluster headaches at age 16 achieved lasting remission by repeatedly using LSD, and then tried psilocybin-containing mushrooms every 3 months.

We surveyed people with cluster headache who reported using psilocybin or LSD specifically to treat their disorder, and found that 58% had never used these drugs except to treat their cluster headache, and 25% had used them for recreational purposes only in the remote past during adolescence.

Twenty-nine subjects had used psilocybin prophylactically during a cluster period, and 15 reported total cessation of attacks. Five of six LSD users reported cluster period termination, and 22 reported partial or complete efficacy from sub-hallucinogenic doses of psilocybin or LSD.

This study relies on participants’ retrospective reports and may be subject to recall bias, selection bias, and placebo effects. However, the study shows that psilocybin and LSD seem to benefit cluster headache by a mechanism unrelated to their psychoactive effects.

There are many cases of people who have taken LSD for remission extension, but they were not yet due for another cluster period.

Acknowledgment

The authors thank Nancy K. Mello, Kimberley Lindsey, and Robert Wold for their comments and assistance with data collection.