The Potential of Psychedelics for the Treatment of Episodic Migraine

Introduction

Classic psychedelics—serotonin 5-HT2A receptor agonists such as psilocybin, DMT and LSD—have a long history of reported therapeutic effects in headache disorders from historical, pharmacological and experiential sources, but rigorous data in migraine are scarce. The review distinguishes classic psychedelics from other psychoactive compounds (for example ketamine, MDMA, ibogaine, THC) and frames therapeutic applications in migraine along three clinical modes: abortive (acute attack relief), preventive (regular dosing to reduce attack frequency), and transitional (one-off or short-course interventions that produce sustained benefit). Cluster headache literature and patient self-administration inform the context but the authors emphasise the need for disorder-specific investigation in migraine. Schindler and colleagues set out to summarise the existing literature relevant to episodic migraine and to present previously unpublished data from the first controlled clinical study of a psychedelic in migraine. The paper aims to evaluate the plausibility and evidence for abortive, preventive and transitional uses of psychedelics in episodic migraine, and to identify priorities and cautions for future research tailored to this condition rather than borrowing protocols from psychiatric trials of psychedelic-assisted psychotherapy.