Repeat Dosing of Psilocybin in Migraine Headache
Repeat Dosing of Psilocybin in Migraine Headache
In seeking to understand the capacity for psilocybin to reduce migraine headache burden, this
 study will investigate single and repeated dosing of psilocybin up to two doses. In seeking
 to identify an underlying mechanism in psilocybin's effects, neuroinflammatory markers for
 migraine headache will be measured.
Migraine headache is a common medical condition and a top cause of disability worldwide.
 Treatment options for migraine headache are many and varied, though an approximated 10% of
 migraineurs is refractory to medication and thus, there is a need to develop alternative
 treatments. There is anecdotal evidence supporting lasting therapeutic effects after limited
 dosing of psilocybin and related compounds in headache disorders. The cause of this unique
 effect remains unknown, though the drug class has demonstrable anti-inflammatory activity, a
 biological process relevant to migraine and other headache disorders. In seeking to
 understand the capacity for psilocybin to reduce migraine headache burden, this study will
 investigate single and repeated dosing of psilocybin up to two doses. In seeking to identify
 an underlying mechanism in psilocybin's effects, neuroinflammatory markers for migraine
 headache will be measured. The results from this study will serve in the development of
 larger investigations seeking to understand the effects of psilocybin and related compounds
 in headache disorders.
Inclusion Criteria:

 -  Diagnosis of migraine headache per ICHD-3 criteria

 -  Typical pattern of migraine attacks with approximately two migraines or more weekly

 -  Attacks are managed by means involving no more than twice weekly triptan use

 Exclusion Criteria:

 -  Axis I psychotic or manic disorder (e.g., schizophrenia, bipolar I, depression with
 psychosis)

 -  Axis I psychotic or manic disorder in first degree relative

 -  Unstable medical condition; severe renal, cardiac, or hepatic disease; pacemaker; or
 serious central nervous system pathology

 -  Pregnant, breastfeeding, lack of adequate birth control

 -  History of intolerance to psilocybin, lysergic acid diethylamide (LSD), or related
 compounds

 -  Drug abuse within the past 3 months (excluding tobacco)

 -  Urine toxicology positive to drugs of abuse

 -  Alcohol use of >21 drinks per week (males); >14 drinks per week (females; NIAAA
 guidelines)

 -  Use of alcohol in the week prior to the first test day

 -  Use of vasoconstrictive medications (i.e., sumatriptan, pseudoephedrine, midodrine)
 within 5 half-lives of test days

 -  Use of serotonergic antiemetics (i.e., ondansetron) in the past 2 weeks

 -  Use of antidepressant medication (i.e., TCA, MAOI, SSRI) in the past 6 weeks

 -  Use of steroids or certain other immunomodulatory agents (i.e., azathioprine) in the
 past 2 weeks

 -  Use of migraine onabotulinum toxin (i.e., Botox) or monoclonal antibodies against CGRP
 or its receptor (i.e., erenumab) in the past month or while therapeutic effects are
 still present