Cannabinoid Hyperemesis Syndrome

Heise, Lynn

doi:10.1097/tme.0000000000000062

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Our review of the literature identified a total of 25 case series (n = 271) and 105 individual case reports of patients identified with CHS (Table ) . Most of the reported case series and case studies predated the publication of Rome IV criteria for CHS.…”

Section: Resultsmentioning

confidence: 99%

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

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Cannabis is commonly used in cyclic vomiting syndrome (CVS) due to its antiemetic and anxiolytic properties. Paradoxically, chronic cannabis use in the context of cyclic vomiting has led to the recognition of a putative new disorder called cannabinoid hyperemesis syndrome (CHS). Since its first description in 2004, numerous case series and case reports have emerged describing this phenomenon. Although not pathognomonic, a patient behavior called “compulsive hot water bathing” has been associated with CHS. There is considerable controversy about how CHS is defined. Most of the data remain heterogenous with limited follow‐up, making it difficult to ascertain whether chronic cannabis use is causal, merely a clinical association with CVS, or unmasks or triggers symptoms in patients inherently predisposed to develop CVS. This article will discuss the role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, in order to address controversies in this context. To this objective, we have collated and analyzed published case series and case reports on CHS in order to determine the number of reported cases that meet current Rome IV criteria for CHS. We have also identified limitations in the existing diagnostic framework and propose revised criteria to diagnose CHS. Future research in this area should improve our understanding of the role of cannabis use in cyclic vomiting and help us better understand and manage this disorder.

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Section: Resultsmentioning

confidence: 99%

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Venkatesan

Levinthal

et al. 2019

Neurogastroenterology Motil

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“…In the last years, increasing cases with a cannabis-hyperemesis syndrome were noticed, which characteristically occurred in frequent and long-term cannabis users and vanished in their next 5–20 abstinent days 83–85. In order to differentiate this condition from CWS, we studied the course of the item “nausea” in the “cannabis burdened” sample mentioned earlier and found no correlation (r=−0.14 to 0.19) with the other items of MWC, whose internal consistency did not change, if “nausea” was excluded from the scale 36.…”

Section: The Role Of Nausea In Cwsmentioning

confidence: 99%

The cannabis withdrawal syndrome: current insights

Bonnet¹,

Preuss

2017

SAR

184

127

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The cannabis withdrawal syndrome (CWS) is a criterion of cannabis use disorders (CUDs) (Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition) and cannabis dependence (International Classification of Diseases [ICD]-10). Several lines of evidence from animal and human studies indicate that cessation from long-term and regular cannabis use precipitates a specific withdrawal syndrome with mainly mood and behavioral symptoms of light to moderate intensity, which can usually be treated in an outpatient setting. Regular cannabis intake is related to a desensitization and downregulation of human brain cannabinoid 1 (CB1) receptors. This starts to reverse within the first 2 days of abstinence and the receptors return to normal functioning within 4 weeks of abstinence, which could constitute a neurobiological time frame for the duration of CWS, not taking into account cellular and synaptic long-term neuroplasticity elicited by long-term cannabis use before cessation, for example, being possibly responsible for cannabis craving. The CWS severity is dependent on the amount of cannabis used pre-cessation, gender, and heritable and several environmental factors. Therefore, naturalistic severity of CWS highly varies. Women reported a stronger CWS than men including physical symptoms, such as nausea and stomach pain. Comorbidity with mental or somatic disorders, severe CUD, and low social functioning may require an inpatient treatment (preferably qualified detox) and post-acute rehabilitation. There are promising results with gabapentin and delta-9-tetrahydrocannabinol analogs in the treatment of CWS. Mirtazapine can be beneficial to treat CWS insomnia. According to small studies, venlafaxine can worsen the CWS, whereas other antidepressants, atomoxetine, lithium, buspirone, and divalproex had no relevant effect. Certainly, further research is required with respect to the impact of the CWS treatment setting on long-term CUD prognosis and with respect to psychopharmacological or behavioral approaches, such as aerobic exercise therapy or psychoeducation, in the treatment of CWS. The up-to-date ICD-11 Beta Draft is recommended to be expanded by physical CWS symptoms, the specification of CWS intensity and duration as well as gender effects.

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“…101 The most commonly reported gastrointestinal side effect is the development of cannabis hyperemesis syndrome. 102,103 This syndrome, seen in chronic cannabis users, is characterized by recurrent episodes of severe nausea, intractable vomiting, and abdominal pain, with a diagnosis based on the Rome IV criteria. 104,105 The pathophysiology of the syndrome remains unknown; however, there may be an underlying genetic predisposition.…”

Section: Long Termmentioning

confidence: 99%

Insights into the role of cannabis in the management of inflammatory bowel disease

Picardo

Kaplan

Sharkey

et al. 2019

Therap Adv Gastroenterol

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Over the last decade, interest in the therapeutic potential of cannabis and its constituents (e.g. cannabidiol) in the management of inflammatory bowel diseases (IBD) has escalated. Cannabis has been increasingly approved for a variety of medical conditions in several jurisdictions around the world. In animal models, cannabinoids have been shown to improve intestinal inflammation in experimental models of IBD through their interaction with the endocannabinoid system. However, the few randomized controlled trials of cannabis or cannabidiol in patients with IBD have not demonstrated efficacy in modulating inflammatory disease activity. Cannabis may be effective in the symptomatic management of IBD. Given the increasing utilization and cultural acceptance of cannabis, physicians need to be aware of its safety and efficacy in order to better counsel patients. The aim of this review is to provide an overview of the role of cannabis in the management of patients with IBD.

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Cannabinoid Hyperemesis Syndrome

Cited by 10 publications

References 11 publications

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome

The cannabis withdrawal syndrome: current insights

Insights into the role of cannabis in the management of inflammatory bowel disease

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