Researchers to trial psilocybin as hope for ‘screwdriver behind the eye’ cluster headaches

This article was originally published by Ashleigh Gleeson, Herald Sun on 22 January. Licensed by Copyright Agency. Do not copy this work without permission.

A confronting video has captured the moment a father-of-two is in so much pain from a headache that an ambulance is called. It’s a kind that affects one in every 1000 Australians. Could magic mushrooms be a possible way to help?

Two weeks ago Ben Fleming was lying on the floor moaning in pain.

In a confronting video captured by his wife of 18 years, his hands are clutched to his head and he writhes around on the floor in their Adelaide home.

The 43-year-old father-of-two is in the midst of a cluster headache, also known as “suicide headaches” due to how unbearable they are.

It is a debilitating condition that is believed to affect one in every 1000 Australians.

It’s so bad in the moment captured in the video that an ambulance was called.

Mr Fleming said he used to be an alcoholic.

After he became sober, almost six years ago, the headaches started.

He gets them daily – cluster headaches can either be episodic or chronic – and they last about 45 minutes.

"I grinned and bore it because I thought it was linked to that," he said.

However it was an unusual coincidence: consuming alcohol is a known trigger for cluster headache attacks and stopping drinking would have helped.

Once every three to six months a really bad cluster headache comes along for Mr Fleming that makes him feel such an intense and crippling pain he can’t stand it.

The video from just two weeks ago is one such example.

"I get a bout of really intense clusters every few months, the pain is dialled up to 11," he said.

"It starts on the side of my head and it very quickly goes from being a tap on the side of the head to being like someone has got a little screwdriver and is wiggling it around behind my eye."

"It is so sharp, and then it does this thing … it comes back again stronger when you’re catching your breath and it hits you again and stops you being able to breathe properly you’re constantly in a state of shock from that last wave of pain."

Mr Fleming, who previously worked as a freelance film producer and in IT, isn’t employed at the moment.

He said this was due to him being unreliable due to his cluster headaches.

This masthead has seen a copy of his medical history with his GP that lists cluster headaches.

He said he was formally diagnosed about two years ago.

The recent ambulance clinical record also documents his complaint of cluster headaches in the notes.

Mr Fleming was among more than 200 Australians who self-reported cluster headaches and recently took part in a survey conducted by The George Institute for Global Health, an independent global medical research institute run under UNSW.

The results, published in Headache: The Journal of Head and Face Pain, found that only 6 per cent of the patients considered their treatment to be totally effective.

However one in four participants hadn’t seen a healthcare provider for cluster headache management and most had only seen a GP rather than a neurologist.

The institute was last year awarded $800,000 from the federal government’s Medical Research Future Fund to investigate using psilocybin, the active component of magic mushrooms, to treat cluster headaches.

Its survey found that 62 per cent of sufferers were interested in participating in cluster headache trials and within that group 66 per cent were very open to that involving psilocybin.

It comes after two small overseas studies that investigated magic mushrooms as a treatment for cluster headaches had varied results.

The first was a US study where 16 participants kept headache diaries for 10 weeks.

Some were put on a dose of psilocybin every five days, while others were given placebos.

It did not find a statistically significant difference between those who were given the magic mushrooms or placebos, with the authors noting a larger study was needed.

Meanwhile, a Danish study involving 10 patients who kept headache diaries over 10 weeks found that cluster headache attack frequency decreased an average of 31 per cent in those given psilocybin.

These reductions, however, were variable among the different patients, so the treatment might only be effective for some people.

One patient experienced 21 weeks complete remission.

Faraidoon Haghdoost, research fellow for headache disorders at the George Institute, said that they were looking at carrying out a controlled, randomised trial involving psilocybin with 40 cluster headache sufferers in Australia.

Dr Haghdoost said it would be one of the first investigator-initiated headache trials to be carried out here as most were funded by pharmaceutical companies.

He said there was a part of the brain called the hypothalamus – which is the internal clock that regulates day and night cycles – which appeared to go out of balance during a cluster headache.

This triggered the largest nerve in the brain and led to the unbearable pain.

Dr Haghdoost said there was a suggestion magic mushrooms helped reset the hypothalamus.

He also noted that there could be a range of side effects from taking magic mushrooms.

"They are sometimes hallucinations, which can include visions or hearing things, you might have dreams or symptoms like a change in blood pressure or pulse rate or some people might feel nausea or vomiting," he said.

He said they would monitor the participants in their trial for six hours after taking the magic mushroom dose to ensure they were safe.

Although the survey results have now been published, the institute still wants sufferers to fill out the form if they are interested in taking part in the trial, as screening will need to be carried out to make sure people are suitable.