Cannabis Hyperemesis Syndrome (CHS) is a clinical disorder characterized by cyclic episodes of severe nausea and intractable vomiting in the setting of chronic, heavy cannabis use. Despite the well-established antiemetic properties of cannabinoids, CHS represents a paradoxical proemetic effect of prolonged high-dose cannabis exposure. Patients classically exhibit compulsive hot water bathing behavior that temporarily relieves symptoms. The clinical course comprises three phases: prodromal (morning nausea, abdominal discomfort), hyperemetic (severe cyclic vomiting, dehydration), and recovery (symptom resolution upon cannabis cessation). The pathophysiology involves disruption of the endocannabinoid system, TRPV1 signaling dysregulation, HPA axis abnormalities, and gastrointestinal dysmotility.
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name: Cannabis Hyperemesis Syndrome
creation_date: '2026-03-03T22:51:00Z'
updated_date: '2026-05-08T18:54:20Z'
description: >
Cannabis Hyperemesis Syndrome (CHS) is a clinical disorder characterized by
cyclic episodes of severe nausea and intractable vomiting in the setting of
chronic, heavy cannabis use. Despite the well-established antiemetic properties
of cannabinoids, CHS represents a paradoxical proemetic effect of prolonged
high-dose cannabis exposure. Patients classically exhibit compulsive hot water
bathing behavior that temporarily relieves symptoms. The clinical course
comprises three phases: prodromal (morning nausea, abdominal discomfort),
hyperemetic (severe cyclic vomiting, dehydration), and recovery (symptom
resolution upon cannabis cessation). The pathophysiology involves disruption of
the endocannabinoid system, TRPV1 signaling dysregulation, HPA axis
abnormalities, and gastrointestinal dysmotility.
category: Complex
disease_term:
preferred_term: cannabinoid hyperemesis syndrome
term:
id: MONDO:0100094
label: cannabinoid hyperemesis syndrome
parents:
- Gastrointestinal Disease
- Substance-Related Disorder
synonyms:
- Cannabinoid Hyperemesis Syndrome
- CHS
pathophysiology:
- name: Endocannabinoid System Dysregulation
description: >
Chronic high-dose cannabis use overwhelms the endocannabinoid system, which
normally regulates stress response, allostasis, thermoregulation, and
gastrointestinal motility via CB1 receptors. Prolonged THC exposure at the
CB1 receptor produces changes that can dysregulate stress and anxiety
responses, thermoregulation, the TRPV1 system, and multiple neurotransmitter
systems. THC accumulates in body fat and may produce a reintoxication effect
during stress or fasting, precipitating acute episodes.
biological_processes:
- preferred_term: Cannabinoid signaling pathway
term:
id: GO:0038171
label: cannabinoid signaling pathway
modifier: ABNORMAL
- preferred_term: G protein-coupled receptor signaling pathway
term:
id: GO:0007186
label: G protein-coupled receptor signaling pathway
- preferred_term: Response to stress
term:
id: GO:0006950
label: response to stress
genes:
- preferred_term: CNR1
term:
id: hgnc:2159
label: CNR1
cell_types:
- preferred_term: Neuron
term:
id: CL:0000540
label: neuron
locations:
- preferred_term: Brain
term:
id: UBERON:0000955
label: brain
- preferred_term: Stomach
term:
id: UBERON:0000945
label: stomach
downstream:
- target: HPA Axis Disruption
description: >
Chronic CB1 receptor stimulation disrupts normal HPA axis feedback and
sympathetic nervous system response.
- target: Gastrointestinal Dysmotility
description: >
CB1 receptor activation in the enteric nervous system delays gastric
emptying and alters intestinal motility.
- target: TRPV1 Receptor Dysregulation
description: >
Endocannabinoid system derangement disrupts the interrelated TRPV1 system,
affecting thermoregulation and emetic control.
evidence:
- reference: PMID:32656345
reference_title: "Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms."
supports: SUPPORT
evidence_source: OTHER
snippet: prolonged high doses of the main psychotropic compound in cannabis, Δ9-tetrahydrocannabinol (THC), result in changes to the endocannabinoid system by acting on the cannabinoid 1 (CB1) receptor. These endocannabinoid system changes can dysregulate stress and anxiety responses, thermoregulation, the transient receptor potential vanilloid system, and several neurotransmitters systems, and are thus potential candidates for mediating the pathophysiology of CHS.
explanation: Directly describes how chronic THC exposure alters the endocannabinoid system via CB1 receptors, dysregulating multiple downstream systems.
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: OTHER
snippet: The endocannabinoid system is a complex and important regulator of stress response and allostasis, and it is occasionally overwhelmed from excessive cannabis use.
explanation: Supports the role of endocannabinoid system disruption as the central mechanism in CHS.
- name: HPA Axis Disruption
description: >
The endocannabinoid system normally exerts negative feedback on the
hypothalamic-pituitary-adrenal (HPA) axis. Chronic cannabis use disrupts this
feedback mechanism. CB1 receptor activation in the hypothalamus and pituitary
modulates all hypothalamic-pituitary axes. Acute episodes may be precipitated
by stress or fasting in chronic users with abnormal HPA axis feedback and
sympathetic nervous system response. Stress-induced lipolysis can mobilize
THC stored in adipose tissue, creating a positive feedback loop.
biological_processes:
- preferred_term: Regulation of hormone secretion
term:
id: GO:0046883
label: regulation of hormone secretion
modifier: ABNORMAL
- preferred_term: Lipid catabolic process
term:
id: GO:0016042
label: lipid catabolic process
cell_types:
- preferred_term: Adipocyte
term:
id: CL:0000136
label: adipocyte
locations:
- preferred_term: Brain
term:
id: UBERON:0000955
label: brain
downstream:
- target: Cyclic Nausea and Vomiting
description: >
HPA axis disruption and THC mobilization from fat stores perpetuate
emetic episodes during stress or fasting.
evidence:
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: OTHER
snippet: Acute episodes of CHS may be precipitated by stress or fasting in chronic cannabis users who may have pre-existing abnormal hypothalamic-pituitary-adrenal axis feedback and sympathetic nervous system response.
explanation: Identifies HPA axis abnormalities and stress as precipitants for CHS episodes.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: OTHER
snippet: CB1 receptor activation in the hypothalamus and pituitary gland results in modulation of all hypothalamic-pituitary axes
explanation: Demonstrates that cannabinoid signaling via CB1 receptors directly modulates hypothalamic-pituitary function.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: OTHER
snippet: THC accumulates largely within body fat which serves as a long-term storage site for the drug [20,22].
explanation: Explains the mechanism by which THC mobilization from adipose stores creates a positive feedback loop during stress.
- name: TRPV1 Receptor Dysregulation
description: >
The transient receptor potential vanilloid 1 (TRPV1) receptor system is
dysregulated in CHS through its complex interrelation with the endocannabinoid
system. The dramatic relief of CHS symptoms from hot water and topical
capsaicin (both TRPV1 agonists) provides evidence for this mechanism. TRPV1
activation by heat or capsaicin modulates tachykinins, somatostatin, CGRP,
and histaminergic, cholinergic, and serotonergic transmission, producing
antiemetic effects. Cannabinoid receptor desensitization in the setting of
chronic use disrupts this TRPV1-endocannabinoid interaction.
biological_processes:
- preferred_term: Sensory perception of temperature stimulus
term:
id: GO:0050951
label: sensory perception of temperature stimulus
- preferred_term: Temperature homeostasis
term:
id: GO:0001659
label: temperature homeostasis
genes:
- preferred_term: TRPV1
term:
id: hgnc:12716
label: TRPV1
cell_types:
- preferred_term: Neuron
term:
id: CL:0000540
label: neuron
downstream:
- target: Compulsive Hot Bathing
description: >
Heat-induced TRPV1 activation provides temporary symptom relief, driving
the compulsive bathing behavior.
evidence:
- reference: PMID:28730896
reference_title: "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment."
supports: SUPPORT
evidence_source: OTHER
snippet: Cannabinoid hyperemesis syndrome may result from a derangement in the endocannabinoid system secondary to chronic exogenous stimulation. The relief of cannabinoid hyperemesis syndrome symptoms from heat and use of transient receptor potential vanilloid 1 agonists suggests a complex interrelation between the endocannabinoid system and transient receptor potential vanilloid 1.
explanation: Directly links TRPV1 dysregulation to CHS pathophysiology and explains how heat and capsaicin provide relief through TRPV1 activation.
- reference: PMID:28730896
reference_title: "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment."
supports: SUPPORT
evidence_source: OTHER
snippet: Transient receptor potential vanilloid 1 activation by heat or capsaicin results in modulation of tachykinins, somatostatin, pituitary adenylate-cyclase activating polypeptide, and calcitonin gene-related peptide as well as histaminergic, cholinergic, and serotonergic transmission. These downstream effects represent further possible explanations for transient receptor potential vanilloid 1-associated antiemesis.
explanation: Details the downstream neurohumoral effects of TRPV1 activation that mediate antiemetic relief in CHS.
- reference: PMID:32656345
reference_title: "Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms."
supports: SUPPORT
evidence_source: OTHER
snippet: These endocannabinoid system changes can dysregulate stress and anxiety responses, thermoregulation, the transient receptor potential vanilloid system, and several neurotransmitters systems
explanation: Identifies TRPV1 system dysregulation as a potential mechanism in CHS.
- name: Gastrointestinal Dysmotility
description: >
CB1 receptors in the gastrointestinal tract regulate gut motility. Chronic
cannabis exposure leads to delayed gastric emptying and reduced intestinal
motility. This is paradoxical because delayed gastric emptying would normally
promote nausea and vomiting, but the antiemetic CNS properties of cannabinoids
usually mask this effect. In CHS, the proemetic peripheral effects of cannabis
on the gut override its antiemetic CNS properties. Delayed gastric emptying
appears particularly resistant to tolerance development.
biological_processes:
- preferred_term: Gastric emptying
term:
id: GO:0035483
label: gastric emptying
modifier: DECREASED
- preferred_term: Intestinal motility
term:
id: GO:0120054
label: intestinal motility
modifier: ABNORMAL
cell_types:
- preferred_term: Enteric neuron
term:
id: CL:0007011
label: enteric neuron
- preferred_term: Epithelial cell of stomach
term:
id: CL:0002178
label: epithelial cell of stomach
locations:
- preferred_term: Stomach
term:
id: UBERON:0000945
label: stomach
downstream:
- target: Abdominal Pain
- target: Cyclic Nausea and Vomiting
evidence:
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
snippet: CB1 receptor activation reduces gastric motility and results in delayed gastric emptying in rat models
explanation: Demonstrates that CB1 activation delays gastric emptying, contributing to the gastrointestinal dysfunction in CHS.
evidence_source: MODEL_ORGANISM
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: OTHER
snippet: in susceptible individuals the pro-emetic effect of cannabis on the gut (e.g. delayed gastric emptying) overrides its anti-emetic CNS properties
explanation: Directly describes the proposed mechanism where peripheral proemetic effects of cannabis override central antiemetic effects.
phenotypes:
- category: Gastrointestinal
name: Cyclic Nausea and Vomiting
frequency: OBLIGATE
diagnostic: true
description: >
Severe, cyclic episodes of nausea and intractable vomiting are the hallmark
of CHS. Patients may vomit profusely, often without warning, and can retch
up to five times per hour during the hyperemetic phase. The hyperemetic phase
usually ceases within 48 hours.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "the frequency of major characteristics was as follows: history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%)"
explanation: Systematic review identifies cyclic nausea and vomiting as present in 100% of CHS cases.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: The hyperemetic phase is characterized by paroxysms of intense and persistent nausea and vomiting, commonly described as overwhelming and incapacitating. Patients vomit profusely, often without warning and can vomit and retch up to five times per hour
explanation: Provides detailed clinical description of the vomiting episodes characteristic of CHS.
phenotype_term:
preferred_term: Cyclic nausea and vomiting
term:
id: HP:0002017
label: Nausea and vomiting
- category: Behavioral
name: Compulsive Hot Bathing
frequency: VERY_FREQUENT
diagnostic: true
description: >
Compulsive hot water bathing is a pathognomonic behavioral feature of CHS.
Patients learn that hot showers or baths provide rapid but temporary symptom
relief and engage in this behavior repetitively during the hyperemetic phase.
The effects are temperature-dependent, fast acting, but short-lived.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "compulsive hot baths with symptom relief (92.3%)"
explanation: Systematic review reports compulsive hot bathing with symptom relief in 92.3% of cases.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Patients often demonstrate the learned behavior of frequent hot bathing, which produces temporary cessation of nausea, vomiting, and abdominal pain.
explanation: Describes the compulsive hot bathing behavior and its temporary symptom-relieving effect.
- reference: PMID:28370228
reference_title: "Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Hot showers and baths were cited in all level-4 and -5 articles as universally effective.
explanation: Systematic review confirms that hot water bathing is universally reported as effective for symptom relief.
phenotype_term:
preferred_term: Compulsive hot bathing behavior
term:
id: HP:0000722
label: Compulsive behaviors
- category: Gastrointestinal
name: Abdominal Pain
frequency: VERY_FREQUENT
description: >
Diffuse but relatively mild abdominal pain accompanies vomiting episodes
in most CHS patients.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "abdominal pain (85.1%)"
explanation: Systematic review reports abdominal pain in 85.1% of CHS cases, consistent with very frequent classification.
phenotype_term:
preferred_term: Abdominal pain
term:
id: HP:0002027
label: Abdominal pain
- category: General
name: Dehydration
frequency: FREQUENT
description: >
Profuse vomiting leads to dehydration and electrolyte abnormalities. Patients
may require intravenous fluid resuscitation during the hyperemetic phase.
evidence:
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: OTHER
snippet: CHS patients frequently present to the emergency department and may require treatment for intractable emesis, dehydration, and electrolyte abnormalities.
explanation: Identifies dehydration and electrolyte abnormalities as common presentations requiring ED treatment.
phenotype_term:
preferred_term: Dehydration
term:
id: HP:0001944
label: Dehydration
- category: General
name: Weight Loss
frequency: FREQUENT
description: >
Many patients experience marked weight loss during the hyperemetic phase,
with some losing 5 kg or more during their illness.
evidence:
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: approximately 70% of patients reported marked weight loss of at least 5 kg during their illness
explanation: Reports significant weight loss in a majority of CHS patients.
phenotype_term:
preferred_term: Weight loss
term:
id: HP:0001824
label: Weight loss
environmental:
- name: Chronic Cannabis Use
description: >
Daily to weekly cannabis use is the primary and necessary risk factor for CHS.
Patients are typically young adults with a long history of chronic use, often
exceeding 3-5 times per day. The average duration of cannabis use prior to
onset of symptoms can be many years, though onset within 1-3 years has been
reported.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "history of regular cannabis for any duration of time (100%), cyclic nausea and vomiting (100%), resolution of symptoms after stopping cannabis (96.8%)"
explanation: Systematic review confirms that regular cannabis use is present in 100% of CHS cases.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: In nearly all cases there is a delay of several years in the onset of symptoms preceded by chronic marijuana abuse
explanation: Confirms the requirement for prolonged chronic cannabis use before CHS develops.
exposure_term:
preferred_term: Cannabis exposure
term:
id: ECTO:0100005
label: exposure to cannabis
- name: High-Potency THC Products
description: >
Higher THC concentrations and increasing cannabis potency may increase the
risk of developing CHS. CHS has become more prevalent with increasing
cannabis potency and legalization.
evidence:
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: CHS has become more prevalent with increasing cannabis potency and use, as enabled by various states having legalized the recreational use of cannabis.
explanation: Links increasing cannabis potency and legalization to rising CHS prevalence.
exposure_term:
preferred_term: High-potency cannabis exposure
term:
id: ECTO:0100005
label: exposure to cannabis
diagnosis:
- name: Clinical diagnosis by cannabis exposure and cyclic vomiting pattern
description: >-
CHS diagnosis is clinical, based on chronic cannabis exposure, cyclic
nausea and vomiting, hot bathing behavior, and symptom resolution after
cannabis cessation.
diagnosis_term:
preferred_term: clinical assessment
term:
id: MAXO:0000487
label: clinical assessment
results: Chronic cannabis use with cyclic vomiting, hot bathing relief, and resolution after cessation.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Fourteen diagnostic characteristics were identified, and the frequency
of major characteristics was as follows: history of regular cannabis
for any duration of time (100%), cyclic nausea and vomiting (100%),
resolution of symptoms after stopping cannabis (96.8%), compulsive
hot baths with symptom relief (92.3%)
explanation: The systematic review identifies the major clinical diagnostic characteristics and their frequencies.
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
CHS is a cyclic vomiting syndrome, preceded by daily to weekly
cannabis use, usually accompanied by symptom improvement with hot
bathing, and resolution with cessation of cannabis.
explanation: This summarizes the practical clinical diagnostic pattern.
treatments:
- name: Cannabis Cessation
description: >
Complete cessation of cannabis use is the only definitive treatment for CHS.
Resolution of symptoms occurs in the vast majority of patients who stop using
cannabis, though relapse is common upon resumption of use. Patient education
should emphasize the paradoxical nature of CHS symptoms, as many patients
continue cannabis use believing it will relieve their nausea.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "resolution of symptoms after stopping cannabis (96.8%)"
explanation: Systematic review reports symptom resolution in 96.8% of patients who stop cannabis.
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: OTHER
snippet: Discontinuation of cannabis use is the only assured cure for CHS.
explanation: Identifies cannabis cessation as the only definitive treatment.
- reference: PMID:32656345
reference_title: "Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: The only known way to permanently end CHS, however, is abstinence from cannabinoids.
explanation: Confirms that abstinence from cannabinoids is the only permanent cure.
treatment_term:
preferred_term: Cannabis cessation counseling
term:
id: MAXO:0000077
label: behavioral counseling
- name: Topical Capsaicin
description: >
Topical capsaicin cream applied to the periumbilical area activates TRPV1
receptors, mimicking the effect of hot water bathing and providing
symptomatic relief during acute episodes. Capsaicin binds and activates
TRPV1, triggering desensitization analgesia. Its favorable risk-benefit
profile makes it a reasonable adjunctive treatment.
evidence:
- reference: PMID:28730896
reference_title: "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment."
supports: SUPPORT
evidence_source: OTHER
snippet: Topical capsaicin binds and activates the transient receptor potential vanilloid 1 receptor, triggering influx of calcium and sodium, as well as release of inflammatory neuropeptides leading to transient burning, stinging, and itching. This elicits a novel type of desensitization analgesia.
explanation: Explains the pharmacologic mechanism by which topical capsaicin provides relief through TRPV1 activation.
- reference: PMID:31104487
reference_title: "Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: the limited data on alternative antiemetic therapies and capsaicin's favorable risk-benefit profile make it a reasonable adjunctive treatment option.
explanation: Systematic review supports capsaicin as a reasonable adjunctive treatment despite limited high-quality evidence.
- reference: PMID:28730896
reference_title: "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Topical capsaicin is primarily used for treatment of neuropathic pain, but it has also been used successfully in some 20 cases of cannabinoid hyperemesis syndrome.
explanation: Reports successful use of topical capsaicin in multiple CHS cases.
treatment_term:
preferred_term: Topical capsaicin therapy
term:
id: NCIT:C15986
label: Pharmacotherapy
- name: Antipsychotic Therapy (Haloperidol)
description: >
Haloperidol and other dopamine antagonists provide symptomatic relief in
acute CHS episodes. Standard antiemetics commonly fail in CHS,
necessitating the use of mechanistically logical sedating agents.
Antipsychotics are frequently reported as effective for acute treatment
when conventional antiemetics are ineffective.
evidence:
- reference: PMID:28370228
reference_title: "Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Benzodiazepines, followed by haloperidol and capsaicin, were most frequently reported as effective for acute treatment"
explanation: Systematic review identifies haloperidol as one of the most frequently reported effective acute treatments.
- reference: PMID:29310960
reference_title: "Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department."
supports: SUPPORT
evidence_source: OTHER
snippet: Benzodiazepines and antipsychotics represent logical choices for treatment of CHS because of their powerful sedating effects.
explanation: Supports the use of antipsychotics as mechanistically logical treatment options for CHS.
treatment_term:
preferred_term: Haloperidol therapy
term:
id: NCIT:C15986
label: Pharmacotherapy
- name: Hot Water Hydrotherapy
description: >
Prolonged hot showers or baths provide rapid but temporary symptomatic relief
during acute episodes. This may be explained by heat-induced TRPV1 activation.
The effects are temperature-dependent, fast acting, but short-lived, and this
behavior becomes compulsive in most patients.
evidence:
- reference: PMID:28730896
reference_title: "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Hot water hydrotherapy is a mainstay of self-treatment for cannabinoid hyperemesis syndrome patients. This may be explained by heat-induced transient receptor potential vanilloid 1 activation.
explanation: Explains hot water hydrotherapy as a mainstay treatment with a proposed TRPV1-mediated mechanism.
- reference: PMID:28370228
reference_title: "Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Hot showers and baths were cited in all level-4 and -5 articles as universally effective.
explanation: Systematic review confirms universal effectiveness of hot water bathing across published cases.
treatment_term:
preferred_term: Hydrotherapy
term:
id: MAXO:0000458
label: hydrotherapy
- name: Supportive Care
description: >
Supportive care with intravenous fluids for rehydration, electrolyte
correction, and avoidance of narcotic medications forms the mainstay of
acute management. Standard antiemetics are generally ineffective for CHS.
evidence:
- reference: PMID:28000146
reference_title: "Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Supportive care with intravenous fluids, dopamine antagonists, topical capsaicin cream, and avoidance of narcotic medications has shown some benefit in the acute setting.
explanation: Systematic review identifies supportive care as part of acute management.
- reference: PMID:22150623
reference_title: "Cannabinoid hyperemesis syndrome."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Supportive therapy, albeit not very effective, serves as the mainstay of treatment during this phase of the syndrome
explanation: Confirms supportive therapy as the standard acute-phase treatment despite limited efficacy.
treatment_term:
preferred_term: Supportive care
term:
id: MAXO:0000950
label: supportive care
notes: >
CHS was first described in 2004 by Allen and colleagues. The clinical course
is divided into three phases: prodromal (early morning nausea, abdominal
discomfort, may last months to years), hyperemetic (intense cyclic vomiting,
typically lasting 24-48 hours), and recovery (symptom resolution, weight
regain). The syndrome is likely underreported given its recent recognition
and the broad differential diagnosis of nausea and vomiting. Patients are
typically young adults with a long history of daily cannabis use. Male
predominance has been observed (72.9% in one systematic review). The average
delay in diagnosis can be substantial, with patients averaging 7.1 emergency
department visits prior to diagnosis. CHS is often confused with cyclic
vomiting syndrome (CVS), though the two are distinct entities recognized by
the Rome III criteria. Cannabinoids produce a biphasic effect on nausea and
vomiting, with low doses having an antiemetic effect and high doses producing
emesis. Three cannabinoids in the cannabis plant (THC, cannabidiol, and
cannabigerol) have opposing effects on the emesis response, which may
contribute to the syndrome.
references:
- reference: DOI:10.1159/000520417
title: A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V).
supporting_text: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V).
evidence:
- reference: DOI:10.1159/000520417
reference_title: A Systematic Review on Cannabis Hyperemesis Syndrome and Its Management Options
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V).
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
- reference: DOI:10.1177/0897190020934289
title: 'Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin'
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-term marijuana use.
supporting_text: Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-term marijuana use.
evidence:
- reference: DOI:10.1177/0897190020934289
reference_title: 'Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-term marijuana use.
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
- reference: DOI:10.1371/journal.pone.0303205
title: 'Trends of emergency department visits for cannabinoid hyperemesis syndrome in Nevada: An interrupted time series analysis'
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Cannabis-related emergency department visits have increased after legalization of cannabis for medical and recreational use.
supporting_text: Cannabis-related emergency department visits have increased after legalization of cannabis for medical and recreational use.
evidence:
- reference: DOI:10.1371/journal.pone.0303205
reference_title: 'Trends of emergency department visits for cannabinoid hyperemesis syndrome in Nevada: An interrupted time series analysis'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Cannabis-related emergency department visits have increased after legalization of cannabis for medical and recreational use.
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
- reference: DOI:10.3389/ftox.2024.1465728
title: 'Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure'
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Cannabinoid hyperemesis syndrome presents as a complex of symptoms and signs encompassing nausea, vomiting, abdominal pain, and hot water bathing behavior, most typically in a heavy cannabis user.
supporting_text: Cannabinoid hyperemesis syndrome presents as a complex of symptoms and signs encompassing nausea, vomiting, abdominal pain, and hot water bathing behavior, most typically in a heavy cannabis user.
evidence:
- reference: DOI:10.3389/ftox.2024.1465728
reference_title: 'Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Cannabinoid hyperemesis syndrome presents as a complex of symptoms and signs encompassing nausea, vomiting, abdominal pain, and hot water bathing behavior, most typically in a heavy cannabis user.
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
- reference: DOI:10.3390/jcm14010163
title: Mitigating the Risk of QTc Prolongation When Using Haloperidol for Acute Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents and Young Adults
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use.
supporting_text: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use.
evidence:
- reference: DOI:10.3390/jcm14010163
reference_title: Mitigating the Risk of QTc Prolongation When Using Haloperidol for Acute Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents and Young Adults
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use.
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
- reference: DOI:10.3390/ph17111549
title: A Comprehensive Review and Update on Cannabis Hyperemesis Syndrome
found_in:
- Cannabis_Hyperemesis_Syndrome-deep-research-falcon.md
findings:
- statement: Cannabis, derived from Cannabis sativa plants, is a prevalent illicit substance in the United States, containing over 400 chemicals, including 100 cannabinoids, each affecting the body’s organs differently upon ingestion.
supporting_text: Cannabis, derived from Cannabis sativa plants, is a prevalent illicit substance in the United States, containing over 400 chemicals, including 100 cannabinoids, each affecting the body’s organs differently upon ingestion.
evidence:
- reference: DOI:10.3390/ph17111549
reference_title: A Comprehensive Review and Update on Cannabis Hyperemesis Syndrome
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Cannabis, derived from Cannabis sativa plants, is a prevalent illicit substance in the United States, containing over 400 chemicals, including 100 cannabinoids, each affecting the body’s organs differently upon ingestion.
explanation: Deep research cited this publication as relevant literature for Cannabis Hyperemesis Syndrome.
Cannabis hyperemesis syndrome (CHS) is characterized by stereotyped/cyclic episodes of severe nausea and vomiting (often with abdominal pain) occurring in the setting of chronic cannabis exposure and typically improving with cannabis cessation; a prominent supportive feature is symptomatic relief with compulsive hot bathing/showering. (sorensen2017cannabinoidhyperemesissyndrome pages 1-2, perisetti2020cannabishyperemesissyndrome pages 5-6)
Direct abstract quotes supporting definition - Sorensen et al. (2017) characterize CHS as “a syndrome of cyclic vomiting associated with cannabis use” (systematic review). (sorensen2017cannabinoidhyperemesissyndrome pages 1-2) - Perisetti et al. (2020) describe CHS as “a form of functional gut-brain axis disorder characterized by bouts of episodic nausea and vomiting worsened by cannabis intake” (narrative review). (perisetti2020cannabishyperemesissyndrome pages 5-6)
The evidence base is largely a combination of: (i) aggregated evidence from systematic reviews and narrative reviews; (ii) administrative/claims/EHR-derived epidemiology (e.g., state ED databases); and (iii) case series and a limited number of randomized or pilot randomized trials evaluating acute therapies. (soh2024trendsofemergency pages 1-2, sorensen2017cannabinoidhyperemesissyndrome pages 1-2, merino2024mitigatingtherisk pages 7-9)
CHS is most consistently associated with chronic, heavy cannabis exposure, and symptom resolution after cessation is a key diagnostic feature, supporting a causal role for continued cannabinoid (CB1 agonist) exposure in susceptible individuals. (sorensen2017cannabinoidhyperemesissyndrome pages 1-2, russo2024cannabinoidhyperemesissyndrome pages 3-4)
Exposure-related risk context - Heavy/regular cannabis use is ubiquitous in reported CHS cases, with systematic review evidence showing history of regular cannabis use in 100% of included cases. (sorensen2017cannabinoidhyperemesissyndrome pages 1-2) - CHS appears in the context of changing cannabis markets and legalization/commercialization. In Nevada, CHS ED visit rates increased from 1.07 per 100,000 (pre-commercialization) to 2.22 per 100,000 (post-commercialization) after recreational commercialization (Q3 2017). (soh2024trendsofemergency pages 1-2, soh2024trendsofemergency pages 2-4) - Synthetic cannabinoids are highlighted as potential higher-risk CB1 agonists in mechanistic discussions; ascertainment is limited in routine ED toxicology. (russo2024cannabinoidhyperemesissyndrome pages 2-3, soh2024trendsofemergency pages 5-7)
Direct abstract quote supporting exposure link - Russo & Whiteley (2024) describe CHS as occurring “most typically in a heavy cannabis user” and discuss association with “escalating intake of high potency cannabis” (Frontiers in Toxicology). (russo2024cannabinoidhyperemesissyndrome pages 1-2)
The only consistently supported protective factor in the retrieved evidence is cannabis cessation, which is both diagnostic-supportive (resolution after cessation) and therapeutic. (sorensen2017cannabinoidhyperemesissyndrome pages 1-2, russo2024cannabinoidhyperemesissyndrome pages 4-6)
A current hypothesis is that CHS arises from genetic susceptibility interacting with high cumulative cannabinoid exposure (“toxic exposure”). A 2024 review reports statistically significant differences in several gene variants between CHS cases and heavy cannabis-using controls, consistent with a gene–environment model. (russo2024cannabinoidhyperemesissyndrome pages 1-2)
The most quantitative phenotype frequencies available in the retrieved evidence come from Sorensen et al. (2017), which summarized case literature: - Cyclic nausea/vomiting: 100% (HPO: HP:0002018 Nausea, HP:0002013 Vomiting, HP:0002572 Cyclic vomiting) (sorensen2017cannabinoidhyperemesissyndrome pages 1-2) - Compulsive hot bathing/showering with relief: 92.3% (behavioral/relief feature; suggest HPO proxy HP:0033836 Compulsive bathing behavior and/or thermoregulation-related HP:0012531 Abnormality of temperature regulation) (sorensen2017cannabinoidhyperemesissyndrome pages 1-2, stumpf2021managementofcannabinoid pages 2-3) - Abdominal pain: 85.1% (HPO: HP:0002027 Abdominal pain) (sorensen2017cannabinoidhyperemesissyndrome pages 1-2) - Male predominance: 72.9% in the compiled case literature (note more recent administrative data may show different sex distributions depending on comparator group and ascertainment). (sorensen2017cannabinoidhyperemesissyndrome pages 1-2, soh2024trendsofemergency pages 4-5)
Additional commonly reported phenotype characteristics - Morning predominance and normal bowel patterns between episodes are repeatedly mentioned as typical clinical characteristics in reviews, though without pooled percentages in the retrieved evidence. (stumpf2021managementofcannabinoid pages 1-2, stumpf2021managementofcannabinoid pages 2-3)
CHS is typically episodic with phases (prodromal → hyperemesis → recovery/postdrome) described in reviews; hyperemetic episodes are commonly short (days) but recur over time if exposure persists. (stumpf2021managementofcannabinoid pages 1-2, perisetti2020cannabishyperemesissyndrome pages 5-6)
Although formal QoL instruments were not captured in the retrieved evidence snippets, frequent ED presentations and repeated negative workups are emphasized, indicating substantial functional burden. (stumpf2021managementofcannabinoid pages 1-2, soh2024trendsofemergency pages 1-2)
CHS is not established as a single-gene disorder; instead, it is treated as complex with emerging candidate susceptibility genes.
A 2024 review reports five statistically significant mutations differentiating CHS patients from heavy-cannabis-user controls, implicating: - TRPV1 (heat/capsaicin-responsive receptor) (p = 0.015) - CYP2C9 (THC-metabolizing enzyme) (p = 0.043) - COMT (dopamine catabolism) (p = 0.012) - DRD2 (dopamine D2 receptor) (p = 0.031) - ABCA1 (ATP-binding cassette transporter) (p = 0.012) (russo2024cannabinoidhyperemesissyndrome pages 1-2)
A contrasting point in the same review is that a CNR1 SNP associated with cyclic vomiting syndrome (CVS) was reported absent in tested CHS patients, supporting genetic distinction between CVS and CHS. (russo2024cannabinoidhyperemesissyndrome pages 3-4)
Interpretation note: these findings are presented as recent/innovative and should be treated as hypothesis-generating pending replication and variant-level validation. (russo2024cannabinoidhyperemesissyndrome pages 6-7)
No CHS-specific epigenetic or chromosomal abnormality evidence was identified in the retrieved sources. (russo2024cannabinoidhyperemesissyndrome pages 6-7)
No infectious etiology is suggested in the retrieved evidence. (perisetti2020cannabishyperemesissyndrome pages 5-6)
Mechanistic models converge on dysregulation of the endocannabinoid system (ECS) and downstream emetic circuitry: - Biphasic cannabinoid effect: anti-emetic at low doses and pro-emetic at high doses is emphasized in recent reviews as relevant to CHS pathophysiology. (loganathan2024acomprehensivereview pages 1-2, loganathan2024acomprehensivereview pages 2-4) - CB1 receptor biology in gut and brain: CB1 receptors in the intestinal nerve plexus inhibit GI motility; chronic/high-dose exposure may lead to CB1 desensitization/internalization and paradoxical effects that increase emetogenic transmitter signaling (serotonin, dopamine, substance P). (loganathan2024acomprehensivereview pages 1-2, loganathan2024acomprehensivereview pages 2-4) - TRPV1/heat pathway: TRPV1 involvement is used to explain symptomatic relief with hot bathing and responsiveness to topical capsaicin (a TRPV1 agonist). (stumpf2021managementofcannabinoid pages 2-3, russo2024cannabinoidhyperemesissyndrome pages 1-2) - Thermoregulatory contribution: endocannabinoid thermoregulation is proposed to relate to compulsive hot bathing behavior. (loganathan2024acomprehensivereview pages 1-2)
Upstream trigger: sustained exposure to cannabinoids (particularly high cumulative THC/CB1 agonism) in susceptible individuals → ECS/CB1 dysregulation (desensitization/internalization; altered feedback control) → increased emetogenic neurotransmission in gut–brain pathways and altered GI motility → episodic hyperemesis with abdominal pain → behavioral compensation (hot bathing, possibly via TRPV1-mediated symptom modulation) → downstream complications including dehydration, electrolyte derangements, AKI, and arrhythmia risk (QTc prolongation) exacerbated by vomiting and by some antiemetic drugs. (loganathan2024acomprehensivereview pages 2-4, perisetti2020cannabishyperemesissyndrome pages 5-6, merino2024mitigatingtherisk pages 1-2)
These are ontology suggestions consistent with the mechanisms described in the cited reviews (not direct experimental annotations in CHS patients): - GO (biological process): vomiting reflex; regulation of gastrointestinal motility; neurotransmitter secretion; response to heat; sensory perception of pain; response to xenobiotic stimulus. (loganathan2024acomprehensivereview pages 2-4, stumpf2021managementofcannabinoid pages 2-3) - Cell Ontology (CL): enteric neurons; dorsal vagal complex/brainstem neurons (broadly “neurons” involved in emesis); sensory neurons expressing TRPV1. (loganathan2024acomprehensivereview pages 2-4, russo2024cannabinoidhyperemesissyndrome pages 1-2)
Suggested UBERON terms (broad): stomach; small intestine; enteric nervous system; brainstem. (loganathan2024acomprehensivereview pages 2-4)
Not specifically addressed in the retrieved evidence (no CHS-specific organelle pathology described). (loganathan2024acomprehensivereview pages 2-4)
High-quality prevalence estimates vary due to diagnostic inconsistency and coding limitations; nonetheless, administrative data demonstrate increasing healthcare utilization.
Nevada ED interrupted time series (2013–2021) - CHS ED visits increased over time and rose after recreational commercialization: 1.07 per 100,000 pre-commercialization → 2.22 per 100,000 post-commercialization (Nevada, Q3 2017). (soh2024trendsofemergency pages 1-2) - Demographic characteristics included a largest age group of 21–29 years (35.24% of CHS visits; n = 5,284) and a lower proportion of males among CHS visits than comparator ED visits. (soh2024trendsofemergency pages 4-5, soh2024trendsofemergency pages 2-4)
CHS is best described as multifactorial/complex, with emerging candidate genetic susceptibility loci rather than Mendelian inheritance. (russo2024cannabinoidhyperemesissyndrome pages 1-2)
Rome IV criteria are summarized in reviews and include chronic cannabis use with stereotypical episodic vomiting and improvement with cessation; diagnostic features are summarized in review tables extracted from Loganathan et al. (2024). (perisetti2020cannabishyperemesissyndrome pages 5-6, loganathan2024acomprehensivereview media 73dc557e)
A Rome IV–style criteria summary reported in Perisetti et al. (2020) includes: onset ≥6 months before diagnosis; stereotypical episodes <1 week; ≥3 episodes/year; no vomiting between episodes; association with cannabis use and improvement after cessation. (perisetti2020cannabishyperemesissyndrome pages 5-6)
A key clinical differential is cyclic vomiting syndrome (CVS). Recent genetic discussion notes a CNR1 SNP association in CVS but not in tested CHS patients, supporting distinction. (russo2024cannabinoidhyperemesissyndrome pages 3-4)
CHS is frequently encountered in emergency departments, where misdiagnosis and repeated negative workups are common; supportive care and targeted antiemetics are applied acutely, while long-term resolution typically requires cannabis cessation and behavioral support. (stumpf2021managementofcannabinoid pages 1-2, loganathan2024acomprehensivereview pages 11-12)
Haloperidol (dopamine antagonist) - A randomized controlled trial summarized in Merino et al. (2024) found IV haloperidol (0.05–0.1 mg/kg) superior to ondansetron 8 mg IV for acute CHS: lower rescue antiemetic use (31% vs 59%) and shorter ED stays (3.1 h vs 5.6 h). (merino2024mitigatingtherisk pages 4-5) - Safety: QTc prolongation risk requires attention, especially with electrolyte disturbances; ECG monitoring is recommended for at-risk patients. (merino2024mitigatingtherisk pages 9-10, merino2024mitigatingtherisk pages 6-7)
Topical capsaicin (TRPV1 agonist) - Pilot randomized evidence (summarized by Merino et al. 2024) indicates 0.1% capsaicin improved nausea at 60 minutes, with 29.4% complete nausea relief; retrospective studies indicate reduced need for additional medications in some cohorts. (merino2024mitigatingtherisk pages 7-9, stumpf2021managementofcannabinoid pages 1-2)
Benzodiazepines (e.g., lorazepam) - Frequently reported as effective, especially in pediatric/adolescent literature, and recommended as an alternative when QT risk is a concern. (merino2024mitigatingtherisk pages 6-7, merino2024mitigatingtherisk pages 9-10)
NK-1 antagonists (aprepitant/fosaprepitant) - Emerging evidence supports use as an alternative with low cardiac risk; Merino et al. summarize response rates from related vomiting disorders and CHS-focused reports, including an adolescent abstract reporting 97% overall improvement. (merino2024mitigatingtherisk pages 7-9)
Olanzapine - Discussed as an alternative with relatively low QTc prolongation risk; CHS-specific dosing/efficacy remains limited. (merino2024mitigatingtherisk pages 7-9, merino2024mitigatingtherisk pages 9-10)
Cannabis cessation is the only consistently “proven” intervention and is tightly linked to symptom resolution and diagnostic confirmation. (russo2024cannabinoidhyperemesissyndrome pages 4-6, sorensen2017cannabinoidhyperemesissyndrome pages 1-2)
Behavioral health / relapse prevention Recent reviews emphasize multimodal treatment addressing psychiatric comorbidity and substance use, using psychotherapy plus pharmacotherapy when appropriate. (loganathan2024acomprehensivereview pages 11-12)
Primary prevention is principally avoiding chronic/heavy cannabis exposure and education about CHS risk, especially in high-risk populations and in regions with increased access/potency. (soh2024trendsofemergency pages 1-2, loganathan2024acomprehensivereview pages 11-12)
No naturally occurring CHS analogs in other species were identified in the retrieved evidence for this run. (russo2024cannabinoidhyperemesissyndrome pages 6-7)
No validated model organism systems that recapitulate CHS (cyclic vomiting with hot-bathing relief in the setting of chronic cannabinoid exposure) were identified in the retrieved evidence, although the mechanistic literature references cannabinoid antiemetic/proemetic biology in animal models in general terms. (russo2024cannabinoidhyperemesissyndrome pages 6-7)
References
(loganathan2024acomprehensivereview pages 1-2): Priyadarshini Loganathan, Mahesh Gajendran, and Hemant Goyal. A comprehensive review and update on cannabis hyperemesis syndrome. Pharmaceuticals, 17:1549, Nov 2024. URL: https://doi.org/10.3390/ph17111549, doi:10.3390/ph17111549. This article has 28 citations.
(sorensen2017cannabinoidhyperemesissyndrome pages 1-2): Cecilia J. Sorensen, Kristen DeSanto, Laura Borgelt, Kristina T. Phillips, and Andrew A. Monte. Cannabinoid hyperemesis syndrome: diagnosis, pathophysiology, and treatment—a systematic review. Journal of Medical Toxicology, 13:71-87, Dec 2017. URL: https://doi.org/10.1007/s13181-016-0595-z, doi:10.1007/s13181-016-0595-z. This article has 461 citations.
(perisetti2020cannabishyperemesissyndrome pages 5-6): A. Perisetti, M. Gajendran, C. Dasari, P. Bansal, Muhammad Aziz, Sumant Inamdar, B. Tharian, and H. Goyal. Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Annals of Gastroenterology, 33:571-578, Sep 2020. URL: https://doi.org/10.20524/aog.2020.0528, doi:10.20524/aog.2020.0528. This article has 101 citations.
(senderovich2022asystematicreview pages 1-2): Helen Senderovich, Preet Patel, Briam Jimenez Lopez, and Sarah Waicus. A systematic review on cannabis hyperemesis syndrome and its management options. Medical Principles and Practice, 31:29-38, Nov 2022. URL: https://doi.org/10.1159/000520417, doi:10.1159/000520417. This article has 50 citations and is from a peer-reviewed journal.
(stumpf2021managementofcannabinoid pages 2-3): Janice L. Stumpf and Lauren D. Williams. Management of cannabinoid hyperemesis syndrome: focus on capsaicin. Journal of Pharmacy Practice, 34:786-793, Jul 2021. URL: https://doi.org/10.1177/0897190020934289, doi:10.1177/0897190020934289. This article has 22 citations and is from a peer-reviewed journal.
(stumpf2021managementofcannabinoid pages 1-2): Janice L. Stumpf and Lauren D. Williams. Management of cannabinoid hyperemesis syndrome: focus on capsaicin. Journal of Pharmacy Practice, 34:786-793, Jul 2021. URL: https://doi.org/10.1177/0897190020934289, doi:10.1177/0897190020934289. This article has 22 citations and is from a peer-reviewed journal.
(moses2024exploringalternativetreatments pages 5-6): Tabitha E H Moses. Exploring alternative treatments for acute exacerbations of cannabis hyperemesis syndrome in patients who plan to continue using cannabis. Clinical Research In Practice: The Journal of Team Hippocrates, Nov 2024. URL: https://doi.org/10.22237/crp/1724285340, doi:10.22237/crp/1724285340. This article has 0 citations.
(merino2024mitigatingtherisk pages 1-2): Sandra Merino, Lissette Tordera, Allison Jun, and Sun Yang. Mitigating the risk of qtc prolongation when using haloperidol for acute treatment of cannabinoid hyperemesis syndrome in adolescents and young adults. Journal of Clinical Medicine, 14:163, Dec 2024. URL: https://doi.org/10.3390/jcm14010163, doi:10.3390/jcm14010163. This article has 4 citations.
(merino2024mitigatingtherisk pages 4-5): Sandra Merino, Lissette Tordera, Allison Jun, and Sun Yang. Mitigating the risk of qtc prolongation when using haloperidol for acute treatment of cannabinoid hyperemesis syndrome in adolescents and young adults. Journal of Clinical Medicine, 14:163, Dec 2024. URL: https://doi.org/10.3390/jcm14010163, doi:10.3390/jcm14010163. This article has 4 citations.
(merino2024mitigatingtherisk pages 6-7): Sandra Merino, Lissette Tordera, Allison Jun, and Sun Yang. Mitigating the risk of qtc prolongation when using haloperidol for acute treatment of cannabinoid hyperemesis syndrome in adolescents and young adults. Journal of Clinical Medicine, 14:163, Dec 2024. URL: https://doi.org/10.3390/jcm14010163, doi:10.3390/jcm14010163. This article has 4 citations.
(moses2024exploringalternativetreatments pages 1-3): Tabitha E H Moses. Exploring alternative treatments for acute exacerbations of cannabis hyperemesis syndrome in patients who plan to continue using cannabis. Clinical Research In Practice: The Journal of Team Hippocrates, Nov 2024. URL: https://doi.org/10.22237/crp/1724285340, doi:10.22237/crp/1724285340. This article has 0 citations.
(merino2024mitigatingtherisk pages 9-10): Sandra Merino, Lissette Tordera, Allison Jun, and Sun Yang. Mitigating the risk of qtc prolongation when using haloperidol for acute treatment of cannabinoid hyperemesis syndrome in adolescents and young adults. Journal of Clinical Medicine, 14:163, Dec 2024. URL: https://doi.org/10.3390/jcm14010163, doi:10.3390/jcm14010163. This article has 4 citations.
(soh2024trendsofemergency pages 1-2): Jaeseung Soh, Yonsu Kim, Jay Shen, Mingon Kang, Stefan Chaudhry, Tae Ha Chung, Seo Hyun Kim, Yena Hwang, Daniel Lim, Adam Khattak, Leora Frimer, and Ji Won Yoo. Trends of emergency department visits for cannabinoid hyperemesis syndrome in nevada: an interrupted time series analysis. PLOS ONE, 19:e0303205, May 2024. URL: https://doi.org/10.1371/journal.pone.0303205, doi:10.1371/journal.pone.0303205. This article has 12 citations and is from a peer-reviewed journal.
(soh2024trendsofemergency pages 2-4): Jaeseung Soh, Yonsu Kim, Jay Shen, Mingon Kang, Stefan Chaudhry, Tae Ha Chung, Seo Hyun Kim, Yena Hwang, Daniel Lim, Adam Khattak, Leora Frimer, and Ji Won Yoo. Trends of emergency department visits for cannabinoid hyperemesis syndrome in nevada: an interrupted time series analysis. PLOS ONE, 19:e0303205, May 2024. URL: https://doi.org/10.1371/journal.pone.0303205, doi:10.1371/journal.pone.0303205. This article has 12 citations and is from a peer-reviewed journal.
(soh2024trendsofemergency pages 4-5): Jaeseung Soh, Yonsu Kim, Jay Shen, Mingon Kang, Stefan Chaudhry, Tae Ha Chung, Seo Hyun Kim, Yena Hwang, Daniel Lim, Adam Khattak, Leora Frimer, and Ji Won Yoo. Trends of emergency department visits for cannabinoid hyperemesis syndrome in nevada: an interrupted time series analysis. PLOS ONE, 19:e0303205, May 2024. URL: https://doi.org/10.1371/journal.pone.0303205, doi:10.1371/journal.pone.0303205. This article has 12 citations and is from a peer-reviewed journal.
(merino2024mitigatingtherisk pages 7-9): Sandra Merino, Lissette Tordera, Allison Jun, and Sun Yang. Mitigating the risk of qtc prolongation when using haloperidol for acute treatment of cannabinoid hyperemesis syndrome in adolescents and young adults. Journal of Clinical Medicine, 14:163, Dec 2024. URL: https://doi.org/10.3390/jcm14010163, doi:10.3390/jcm14010163. This article has 4 citations.
(russo2024cannabinoidhyperemesissyndrome pages 4-6): Ethan B. Russo and Venetia L. Whiteley. Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure. Frontiers in Toxicology, Oct 2024. URL: https://doi.org/10.3389/ftox.2024.1465728, doi:10.3389/ftox.2024.1465728. This article has 11 citations.
(loganathan2024acomprehensivereview pages 11-12): Priyadarshini Loganathan, Mahesh Gajendran, and Hemant Goyal. A comprehensive review and update on cannabis hyperemesis syndrome. Pharmaceuticals, 17:1549, Nov 2024. URL: https://doi.org/10.3390/ph17111549, doi:10.3390/ph17111549. This article has 28 citations.
(loganathan2024acomprehensivereview media 73dc557e): Priyadarshini Loganathan, Mahesh Gajendran, and Hemant Goyal. A comprehensive review and update on cannabis hyperemesis syndrome. Pharmaceuticals, 17:1549, Nov 2024. URL: https://doi.org/10.3390/ph17111549, doi:10.3390/ph17111549. This article has 28 citations.
(loganathan2024acomprehensivereview media 15f1dbc6): Priyadarshini Loganathan, Mahesh Gajendran, and Hemant Goyal. A comprehensive review and update on cannabis hyperemesis syndrome. Pharmaceuticals, 17:1549, Nov 2024. URL: https://doi.org/10.3390/ph17111549, doi:10.3390/ph17111549. This article has 28 citations.
(soh2024trendsofemergency pages 5-7): Jaeseung Soh, Yonsu Kim, Jay Shen, Mingon Kang, Stefan Chaudhry, Tae Ha Chung, Seo Hyun Kim, Yena Hwang, Daniel Lim, Adam Khattak, Leora Frimer, and Ji Won Yoo. Trends of emergency department visits for cannabinoid hyperemesis syndrome in nevada: an interrupted time series analysis. PLOS ONE, 19:e0303205, May 2024. URL: https://doi.org/10.1371/journal.pone.0303205, doi:10.1371/journal.pone.0303205. This article has 12 citations and is from a peer-reviewed journal.
(russo2024cannabinoidhyperemesissyndrome pages 3-4): Ethan B. Russo and Venetia L. Whiteley. Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure. Frontiers in Toxicology, Oct 2024. URL: https://doi.org/10.3389/ftox.2024.1465728, doi:10.3389/ftox.2024.1465728. This article has 11 citations.
(russo2024cannabinoidhyperemesissyndrome pages 2-3): Ethan B. Russo and Venetia L. Whiteley. Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure. Frontiers in Toxicology, Oct 2024. URL: https://doi.org/10.3389/ftox.2024.1465728, doi:10.3389/ftox.2024.1465728. This article has 11 citations.
(russo2024cannabinoidhyperemesissyndrome pages 1-2): Ethan B. Russo and Venetia L. Whiteley. Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure. Frontiers in Toxicology, Oct 2024. URL: https://doi.org/10.3389/ftox.2024.1465728, doi:10.3389/ftox.2024.1465728. This article has 11 citations.
(russo2024cannabinoidhyperemesissyndrome pages 6-7): Ethan B. Russo and Venetia L. Whiteley. Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure. Frontiers in Toxicology, Oct 2024. URL: https://doi.org/10.3389/ftox.2024.1465728, doi:10.3389/ftox.2024.1465728. This article has 11 citations.
(loganathan2024acomprehensivereview pages 2-4): Priyadarshini Loganathan, Mahesh Gajendran, and Hemant Goyal. A comprehensive review and update on cannabis hyperemesis syndrome. Pharmaceuticals, 17:1549, Nov 2024. URL: https://doi.org/10.3390/ph17111549, doi:10.3390/ph17111549. This article has 28 citations.