A Systematic Review on Cannabis Hyperemesis Syndrome and its Management Options

Abstract

Introduction: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V). Emerging cases of refractory N/V, associated with chronic cannabis use among adults and older patients have been reported named cannabis hyperemesis syndrome (CHS). CHS is a condition that leads to repeated and severe N/V in long-term users of cannabinoids. Objective: To outline current treatments for the management of CHS. Methods: A systematic review was conducted using PubMed, Ovid MEDLINE, Cochrane Central, EMBASE and Google Scholar. Databases were used to search for articles on CHS published from January 2009 to June 2021, yielding 225 results of which 17 were deemed relevant and underwent review by two separate reviewers. Results: The duration of cannabis administration ranged between six months to 11 years may precipitate symptoms of CHS. The Rome IV diagnostic criteria of CHS requires cannabinoid use and persistence if N/V symptoms for at least the past six months. Cannabis cessation is noted to be the most successful management, but other treatments also demonstrated symptom relief and included hot water hydrotherapy, topical capsaicin cream, haloperidol, droperidol, benzodiazepines, propranolol and aprepitant administration. Conclusion: Overall future research on CHS is needed which enhance knowledge translation, education and creates awareness of the medical community about the side effects of cannabinoids and propose the best treatment options.