It is hoped that, one day, psychedelic drugs might be used by scientists to treat people suffering from chronic headache, migraine and associated cognitive symptoms or brain fog. Though initial research using psilocybin and other psychedelic drugs has garnered some press coverage due to reports that some users experienced lasting benefits after the drug wore off, investigators stress that research is still in the very early stages and is not yet conclusive.
Psilocybin is the active hallucinogenic ingredient found in certain species of mushrooms. It interacts with serotonin receptors in the brain which are responsible for various processes including mood perception sensory processing and certain neurological functions. Scientists are currently investigating the potential effect this interaction could have upon the biological mechanisms linked to migraine and other forms of headache.
A small exploratory studies of the effects of psilocybin in people with migraine, involving 10 patients, published in Neurotherapeutics, indicated that the number of days with migraine decreased more in the two weeks following psilocybin than in what comes next two weeks following placebo. Since the study concluded that a single dose of psilocybin appeared to have effects even after the period of intoxication, the study suggested that psilocybin might have some merit for use in the treatment of migraine. Because the study only investigated a very small sample of 10 people with this condition, it is not possible to generalize the findings to people with migraine.
One more randomized clinical trial studied if 1 or 2 doses of psilocybin could prevent migraine; the trial was conducted in 18 adults, who had at least 2 days of migraine per week. While the numerical findings were promising, the differences between groups were not statistically significant and similar reductions were seen in both groups over the follow-up period of 8 weeks. These findings show the need for larger and more well controlled studies.
Other studies have examined psilocybin in cluster headaches, a disorder characterized by severe attacks in episodes with long remission periods. In a 2022 randomized trial, psilocybin was given in three low doses about five days apart. The psilocybin group experienced a numerical reduction in attacks, although the primary endpoint was statistically not significant; the researchers described the research as exploratory and called for more conclusive evidence.
A minor follow up trial with 10 subjects reported that repetitions in the treatment was linked with significant decrease in cluster headache attacks. Still, the authors conclude that this was a very small sample size to allow conclusion on whether a repetition is safe and effective in clinical practice for long term.
The evidence of a relationship between psychedelics and brain fog is less conclusive. Brain fog isn’t a singular diagnosis, it can be used by people to describe problems with concentration, slowed or delayed thinking, forgetfulness, or a feeling of mental tiredness. These issues may also be present in migraine, sleep disturbances, medication effects stress depression, chronic illness or some other brain disorder. Existing headache literature has looked at attack frequency, attack severity and disability rather than establishing that psychedelics have a direct impact on brain fog.
