People with cluster headache in the Netherlands use illicit drugs more often than the general population: 31.7% reported lifetime use compared to 23.8% in matched controls. Among psilocybin mushroom users, 56% reported a reduction in attack frequency, and 46% reported shorter attacks. Lysergic acid diethylamide users reported frequency reduction in 60% of cases, and heroin users in 50%. Amphetamine users reported shorter attacks in 36% of cases. The authors suggest the higher drug use may reflect genuine symptom relief, placebo effects, personal conviction, or a shared biological basis between cluster headache and addictive behaviors.
Among 24 people with hallucinogen persisting perception disorder (HPPD) presenting as visual snow syndrome, none had migraine, whereas 20 of 37 (54.1%) people with visual snow who had never used illicit drugs before onset had migraine. Symptom severity, measured by the Visual Snow Handicap Inventory, was similar between the groups, with a median score of 38 out of 100. In most HPPD cases (70.9%), visual snow began after ecstasy use; other drugs reported included cannabis, psilocybin mushrooms, and amphetamine. The findings suggest different pathophysiological factors underlie HPPD and visual snow syndrome without prior drug use. Users of ecstasy and other hallucinogens should be warned about the risk of visual snow.