Review: cannabinoid hyperemesis syndrome

December 28, 2011, 12:34 am

★★★½☆

Cannabinoid Hyperemesis Syndrome. Galli JA et al. Curr Drug Abuse Rev 2011 Nov 29. [Epub ahead of print]

Abstract

As TPR has previously discussed, cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which frequent, chronic use of marijuana can cause cyclic vomiting. CHS is characterized by:

  • chronic use of marijuana (usually daily for more than a year)
  • recurrent episodes of severe nausea and vomiting (often with abdominal pain)
  • relief of symptoms on exposure to hot water, leading to compulsive bathing

This review gets granular about the pharmacology of cannabis and the cannabinoid receptors, with a relatively short clinical discussion at the end. It does emphasize that physicians should emphasize the paradoxical nature of CHS in discussions with patients, since the fact that cannabinoids have anti-emetic properties is well known, and it may be difficult to convince the patient that his or her cyclic vomiting is in fact caused by marijuana. Referral to web sources discussing this problem might also help.

By the way, CHS is not as rare as one might think. Although less than 40 cases have been reported in the literature, since posting about it I have heard from several physicians who have each seen numerous cases.

To read my Emergency Medicine News column on cannabinoid hyperemesis syndrome, click here.

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