Psychedelic and nonpsychedelic LSD and psilocybin for cluster headache
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* Wm. Jeptha Davenport

Tupper and colleagues highlight reasons for renewed interest in the use of psychedelic drugs as adjuncts to psychotherapy.1 Clinicians have an interest in extending research into headache medicine, especially the treatment of cluster headaches (prevalence roughly 0.1%) when episodes are refractory to standard therapies, including other serotonergic agents.

Patients with cluster headache have turned to LSD and psilocybin to abort periods of cluster headache.2 This may often occur without the involvement of patients’ health care providers.3 Of interest, an open-label study found that similar compounds (2-bromo-LSD) without psychedelic effect were promising for this purpose.4 I hope that Tupper and colleagues’ contribution to an open discussion of these treatments will encourage more research and better treatment for patients with a variety of disorders presumably linked to serotonin.

## References

1.  Tupper KW, Wood E, Yensen R, et al. Psychedelic medicine: a re-emerging therapeutic paradigm. CMAJ 2015:87:1054–9.
    
    

2.  Sewell RA, Halpern JH, Pope HG Jr., et al. Response of cluster headache to psilocybin and LSD. Neurology 2006;66:1920–2.
    
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3.  Govare A, Leroux E. Licit and illicit drug use in cluster headache. Curr Pain Headache Rep 2014; 18:413.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1007/s11916-014-0413-8&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=24715619&link_type=MED&atom=%2Fcmaj%2F188%2F3%2F217.3.atom) 

4.  Karst M, Halpern JH, Bernateck M, et al. The non-hallucinogen 2-bromo-lysergic acid diethylamide as preventative treatment for cluster headache: an open, non-randomized case series. Cephalalgia 2010;30:1140–4.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1177/0333102410363490&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=20713566&link_type=MED&atom=%2Fcmaj%2F188%2F3%2F217.3.atom) 
    
    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000285053200016&link_type=ISI)