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Cannabinoid Hyperemesis Syndrome

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1. BET 1: Haloperidol in cannabinoid hyperemesis syndrome. (PubMed)

BET 1: Haloperidol in cannabinoid hyperemesis syndrome. A short-cut review was carried out to establish whether haloperidol is effective at treating the symptoms of cannabinoid hyperemesis syndrome (CHS). One study was directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of that paper were tabulated. The clinical bottom line was that no controlled studies exist to report on the use

2018 Emergency Medicine Journal

2. Can cannabinoid hyperemesis syndrome be fatal?

Can cannabinoid hyperemesis syndrome be fatal? Can cannabinoid hyperemesis syndrome be fatal? » The Poison Review Can cannabinoid hyperemesis syndrome be fatal? May 30, 2018, 1:22 pm shutterstock.com/Stanimir G. Stoev Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases. Nourbakhsh M et al. J Forensic Sci 2018 May 15 [Epub ahead of print] This paper reports on 2 fatal cases that the authors argue were attributable to the effects of (CHS). CASE #1: A 27-year-old woman is brought to hospital (...) and vomiting, and discharged home after symptomatic improvement. Gross and histologic findings at autopsy did not reveal a specific causes of death. Extensive toxicology testing was positive for Delta-9-THC and Carboxy-THC. Tests of vitreous humor showed hyponatremia, hypochloremia, hypoglycemia, and elevated urea and creatinine. (Strangely, no electrolyte results are reported on pre-mortem blood.) The death was attributed to complications of cannabinoid hyperemesis syndrome. CASE #2: A 27-year-old man

2018 The Poison Review blog

3. Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. (PubMed)

Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. Cannabinoid hyperemesis syndrome (CHS) is a challenging clinical disorder. CHS patients frequently present to the emergency department and may require treatment for intractable emesis, dehydration, and electrolyte abnormalities. Thought to be a variant of cyclic vomiting syndrome, CHS has become more prevalent with increasing cannabis potency and use, as enabled by various states having legalized

2018 Journal of Emergency Medicine

4. Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin (PubMed)

Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin Cannabinoid hyperemesis syndrome (CHS) is a clinical entity in which marijuana users develop nausea, vomiting, and abdominal pain that improves with hot water bathing or cannabis cessation. Previous models suggest that CHS arises solely from the derangement of cannabinoid receptor type 1 signaling. However, involvement of transient receptor potential vanilloid subtype 1 (TRPV1) receptor, which is activated

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2018 ACG case reports journal

5. Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report (PubMed)

Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report With marijuana legalization, clinicians need to be aware of Cannabinoid Hyperemesis Syndrome (CHS), which may masquerade as other disease states such as uremia.A 37-year-old man with bipolar affective disease treated with lithium had progressive renal insufficiency presumably on the basis of interstitial fibrosis. He developed persistent and severe nausea and vomiting which was assumed to be on the basis

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2018 Canadian journal of kidney health and disease

6. Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Guidelines

Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should (...) Syndrome: Guidelines DATE: 25 June 2012 RESEARCH QUESTION What are the evidence-based guidelines regarding the diagnosis and treatment of cannabinoid hyperemesis syndrome? KEY MESSAGE No relevant evidence-based guidelines regarding the diagnosis and treatment of cannabinoid hyperemesis syndrome were identified. Case reports and literature reviews are included in the appendix. METHODS A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2012, Issue 6

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

7. Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use (PubMed)

Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use Introduction. Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that includes cyclic severe vomiting in subjects who have been consuming large doses of cannabis for several years. One of the major diagnostic criteria is the alleviation of symptoms by hot showers. The syndrome was first described in 2004 and is so far neither completely understood nor well known (...) severe nausea and vomiting ceased by hot showers and resistant to all other treatments. The final diagnosis was not established until his third visit to the ER. Conclusion. CHS is an important differential diagnosis in patients who present with cyclic vomiting and abdominal pain with a history of long-term cannabis use. Recognition of this syndrome is important in order to avoid unnecessary clinical testing and to help the patients break the cycle of drug use.

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2016 Case reports in gastrointestinal medicine

8. Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream

Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream » The Poison Review Case series: treating cannabinoid hyperemesis syndrome with capsaicin cream December 5, 2017, 5:27 pm Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series. Dezieck L et al. Clin Toxicol 2017 Sep;55:908-913. (CHS) is a form of cyclic vomiting characterized by: chronic (...) painful. Second, several patients in this series carried a diagnosis or irritable bowel syndrome, and may have been on chronic opioids. I wonder if some component of their symptoms might properly be attributed to rather than to CHS. Finally, it is important to note that the majority of patients had previous ED visits and hospital admissions for their symptoms, and some had received extensive GI workups including laboratory tests, imaging, and endoscopy. It is possible that if more clinicians were

2017 The Poison Review blog

9. Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series. (PubMed)

Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series. Cannabinoid hyperemesis syndrome (CHS) is an underrecognized diagnosis among adolescents. In the adult literature, it is characterized as nausea, vomiting, and abdominal pain in patients with chronic marijuana use. CHS is often refractory to the standard treatment of nausea and vomiting. Unconventional antiemetics, such as haloperidol, have been successful in alleviating symptoms; however, even 1 (...) dose of haloperidol can lead to grave adverse effects, such as dystonia, extrapyramidal reactions, and neuroleptic malignant syndrome. The use of topical capsaicin cream to treat CHS has been well described in the adult literature. This treatment is cost-effective and is associated with few serious side effects. Here, we describe 2 adolescent patients with nausea, vomiting, and abdominal pain in the setting of chronic cannabis use whose symptoms were not relieved by standard antiemetic therapies

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2017 Pediatrics

10. Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. (PubMed)

Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. Cannabinoid hyperemesis syndrome (CHS) has become more prevalent with increasing cannabis use. CHS is often resistant to standard antiemetics. The objective of this study is to review the current evidence for pharmacologic treatment of CHS. Medline, PsycINFO, DARE, OpenGrey, Google Scholar, and the Cochrane Library were searched from inception to February 2017. Articles were selected and reviewed independently

2017 Pharmacotherapy

11. In Response to Letter to the Editor Regarding: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. (PubMed)

In Response to Letter to the Editor Regarding: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. 28283940 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol In Response to Letter to the Editor Regarding: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. 198 10.1007/s13181-017-0610-z Sorensen Cecilia J (...) 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Jun;13(2):197 28281175 J Med Toxicol. 2017 Mar;13(1):71-87 28000146 Cannabinoids Humans Marijuana Abuse Vomiting Cannabinoid hyperemesis syndrome Cannabis Cyclic vomiting syndrome Haloperidol Marijuana 2017 02 17 2017 02 27 2017 02 23 2017 3 12 6 0 2018 10 10 6 0 2017 3 12 6 0 ppublish 28283940 10.1007/s13181-017-0610-z 10.1007/s13181-017-0610-z PMC5440323 Am J Emerg Med. 2013 Jun;31(6):1003.e5-6 23583118 Am J Ther. 2017 Jan/Feb;24(1):e64-e67

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2017 Journal of medical toxicology : official journal of the American College of Medical Toxicology

12. In Response to: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. (PubMed)

In Response to: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. 28281175 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol In Response to: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. 197 10.1007/s13181-017-0608-6 Routsolias Joanne C JC Clinical PharmD - Emergency Medicine/Toxicology, Cook (...) County Health and Hospitals System, Chicago, IL, 60612, USA. joanne.routsolias@cookcountyhhs.org. eng Letter Comment 2017 03 09 United States J Med Toxicol 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Mar;13(1):71-87 28000146 J Med Toxicol. 2017 Jun;13(2):198 28283940 Cannabinoids Humans Marijuana Abuse Nausea Vomiting 2017 02 11 2017 02 22 2017 02 12 2017 3 11 6 0 2018 10 10 6 0 2017 3 11 6 0 ppublish 28281175 10.1007/s13181-017-0608-6 10.1007/s13181-017-0608-6 PMC5440321 South Med J

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2017 Journal of medical toxicology : official journal of the American College of Medical Toxicology

13. Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment (PubMed)

Cannabinoid hyperemesis and the cyclic vomiting syndrome in adults: recognition, diagnosis, acute and long-term treatment The cannabinoid hyperemesis syndrome (CHS) and the cyclic vomiting syndrome in adults (CVS) are both characterized by recurrent episodes of heavy nausea, vomiting and frequently abdominal pain. Both syndromes are barely known among physicians. Literature is inconsistent concerning clinical features which enable differentiation between CVS and CHS. We performed a literature (...) review using the LIVIVO search portal for life sciences to develop a pragmatic approach towards these two syndromes. Our findings indicate that complete and persistent resolution of all symptoms of the disease following cannabis cessation is the only reliable criterion applicable to distinguish CHS from CVS. Psychiatric comorbidities (e.g. panic attacks, depression), history of migraine attacks and rapid gastric emptying may serve as supportive criteria for the diagnosis of CVS. Compulsive bathing

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2017 GMS German Medical Science

14. The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use (PubMed)

The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use 28353201 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol The Importance of Recognizing Cannabinoid Hyperemesis Syndrome from Synthetic Marijuana Use. 199-200 10.1007/s13181-017-0612-x Liu Xibei X University of Nevada School of Medicine, Las Vegas, NV, USA. Villamagna Angela A University of Nevada (...) School of Medicine, Las Vegas, NV, USA. Yoo Ji J University of Nevada School of Medicine, Las Vegas, NV, USA. jwyoo@medicine.nevada.edu. eng Letter Comment 2017 03 28 United States J Med Toxicol 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Mar;13(1):71-87 28000146 J Med Toxicol. 2017 Jun;13(2):201 28382464 Cannabinoids Humans Marijuana Abuse Marijuana Smoking Marijuana Use Nausea Vomiting 2017 03 09 2017 03 21 2017 3 30 6 0 2018 10 10 6 0 2017 3 30 6 0 ppublish 28353201 10.1007/s13181

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2017 Journal of Medical Toxicology

15. In Reply: “The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use” (PubMed)

In Reply: “The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use” 28382464 2018 10 09 2018 11 13 1937-6995 13 2 2017 06 Journal of medical toxicology : official journal of the American College of Medical Toxicology J Med Toxicol In Reply: "The importance of recognizing cannabinoid hyperemesis syndrome from synthetic marijuana use". 201 10.1007/s13181-017-0613-9 Sorensen Cecilia J CJ Denver Health Residency in Emergency Medicine, Denver Health (...) and Hospital Authority, Denver, CO, 80204, USA. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA. Rocky Mountain Poison & Drug Center, Denver Health and Hospital Authority, Denver, CO, USA. eng K23 GM110516 GM NIGMS NIH HHS United States UL1 TR001082 TR NCATS NIH HHS United States Editorial Comment 2017 04 05 United States J Med Toxicol 101284598 1556-9039 0 Cannabinoids IM J Med Toxicol. 2017 Jun;13(2):199-200 28353201 J Med Toxicol. 2017 Mar;13(1):71-87

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2017 Journal of Medical Toxicology

16. Coronary vasospasm complicating cannabinoid hyperemesis syndrome (PubMed)

Coronary vasospasm complicating cannabinoid hyperemesis syndrome Cannabinoid hyperemesis syndrome (CHS) is a clinical condition that was first described in 2004. The syndrome may occasionally be observed in long-term cannabis users and is characterized by a set of features: severe cyclic nausea and vomiting, recurrent epigastric or periumbilical pain, relief of symptoms with hot baths, and cannabis use cessation. The pathophysiology is not fully understood but is probably related to Cannabinoid (...) consistent with takotsubo cardiomyopathy. However, the patient was readmitted very soon with a ST-elevation myocardial infarction related to coronary vasospasm. While the link between CHS and ACS is not established, CHS patients with atypical pain should be investigated carefully to exclude any serious cardiac event. Cannabinoid hyperemesis syndrome is a rare medical entity than can be observed in some long-term heavy cannabis users. While most patients usually complain of recurrent

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2017 Journal of cardiology cases

17. Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline (PubMed)

Cannabinoid Hyperemesis Syndrome: Public Health Implications and a Novel Model Treatment Guideline Cannabinoid hyperemesis syndrome (CHS) is an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers. Patients often present to the emergency department (ED) repeatedly and undergo extensive evaluations including laboratory examination, advanced imaging, and in some cases unnecessary procedures. They are exposed

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2017 Western Journal of Emergency Medicine

18. Cannabinoid Hyperemesis Syndrome During Pregnancy: A Case Report. (PubMed)

Cannabinoid Hyperemesis Syndrome During Pregnancy: A Case Report. Cannabinoid hyperemesis syndrome (CHS) is a syndrome characterized by chronic marijuana use, cyclic vomiting, and compulsive bathing. Given the similarities this syndrome shares with hyperemesis gravidarum, it is likely that this is a highly underdiagnosed syndrome. We present a case of severe nausea and vomiting during pregnancy that met the criteria for CHS.This case outlines the course of recurrent nausea and vomiting due (...) to cannabinoid hyperemesis in a pregnant patient and illustrates the similarities between hyperemesis gravidarum and CHS and the value of obtaining a complete history that includes the use of marijuana.Recognition of this syndrome will aid in patient care, lessen the economic burden of an extensive workup, and hopefully lessen provider frustration with diagnosis and treatment of a common and underdiagnosed entity.

2017 Journal of Reproductive Medicine

19. Successful Treatment of Suspected Cannabinoid Hyperemesis Syndrome Using Haloperidol in the Outpatient Setting (PubMed)

Successful Treatment of Suspected Cannabinoid Hyperemesis Syndrome Using Haloperidol in the Outpatient Setting Chronic use of cannabis can result in a syndrome of hyperemesis characterized by cyclical vomiting without any other identifiable causes. Cannabinoid hyperemesis syndrome (CHS) is seldom responsive to traditional antiemetic therapies. Despite frequent nausea and vomiting, patients may be reluctant to discontinue use of cannabis. We report a case of severe, refractory CHS with complete

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2016 Case reports in psychiatry

20. Cannabinoid hyperemesis syndrome and the onset of a manic episode (PubMed)

Cannabinoid hyperemesis syndrome and the onset of a manic episode Cannabinoid hyperemesis syndrome is a rare, recently described, clinically diagnosed condition that is characterised by a chronic history of cannabis use, cyclic nausea and vomiting, symptomatic relief with hot water bathing, and resolution with cessation of use. We present a case of this syndrome concurrent in a patient with bipolar mania. We suggest that a 3-week period of vomiting in the context of this syndrome contributed (...) to the precipitation of a manic episode by lowering mood stabiliser serum levels, and that this syndrome will have significant consequences for the patient's mental health. 2016 BMJ Publishing Group Ltd.

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2016 BMJ case reports

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