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The endocannabinoid system in migraine

from bench to pharmacy and back

Tassorelli, Cristinaa,b; Greco, Rosariaa; Silberstein, Stephen D.c

Current Opinion in Neurology: June 2019 - Volume 32 - Issue 3 - p 405–412
doi: 10.1097/WCO.0000000000000688
HEADACHE: Edited by Messoud Ashina and Henrik Winther Schytz

Purpose of review Migraine is a common, highly disabling disorder. Its treatment involves acute and preventive therapy. Many of available preventive medications are not well tolerated, which results in poor compliance and limited effectiveness. Cannabinoids have been proposed for the treatment of migraine but their efficacy and tolerability are controversial.

Recent findings Cannabinoids modulate functions and activity of signaling pathways that have a key role in pain control. Growing preclinical evidence and initial clinical findings suggest that modulation of the endocannabinoid system, via endogenous or exogenous cannabinoids may be relevant for migraine via multiple mechanisms.

Summary The endocannabinoid system qualifies as an interesting area of research worth exploration in the quest for therapeutic targets for the treatment of migraine.

aHeadache Science Center, IRCCS Mondino Foundation

bDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

cJefferson Headache Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

Correspondence to Cristina Tassorelli, MD, PhD, IRCCS C. Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy. Tel: +39 0382380419; fax: +39 0382380448; e-mail:

Copyright © 2019 Wolters Kluwer Health, Inc. All rights resereved.