Cannabinoid Hyperemesis Syndrome StatPearls NCBI Bookshelf

To fully get better, you need to stop using marijuana all together. Some people may get help from drug rehab programs to help them quit. If you stop using marijuana, your symptoms should not come back. The hyperemetic phase may continue until the person completely stops using marijuana.

• CBG has the potential to reverse the antiemetic effects of CBD, suggesting that CHS could result from the interplay between high levels of CBD and its reversal by CBG 25,26.
• Venkatesan et al have proposed a new criterion for CHS with the use of clinical features, cannabis use patterns including duration and frequency, and symptoms resolution after at least 6 months of cessation 48.

Marijuana-Induced Vomiting Syndrome Rising in Young Men

The lack of significant diagnostic findings in CHS patients underscores the importance of a thorough patient history and clinical suspicion. Despite negative workups, physicians must consider CHS when standard treatments fail and patients continue to present with persistent symptoms related to cannabis use. Two treatment patterns were noted in Sifuentes et al.’s long-term follow-up study of CHS patients 105. Some patients require a gradual increase in their maintenance dose to maintain stability, as dose tolerance leads to ‘breakthrough’ vomiting episodes. Once patients achieve stability with TCA therapy, evidenced by no emergency department visits for at least one year, the amitriptyline dosage can often be tapered or discontinued entirely over the following year. Female patients are frequently motivated to taper off amitriptyline in anticipation of pregnancy.

These chemicals can change the time it takes your stomach to empty food. Other pharmacologic alternatives were also explored with mixed to unproven efficacy. Exogenous https://ecosoberhouse.com/article/why-cant-i-cut-down-or-control-my-drinking/ ligands, such as N-acyl ethanolamines and mono-acyl-glycerols, include notable compounds like THC (which contains a dibenzopyran ring), cannabidiol, cannabigerol, and cannabinol 23,30.

Cannabinoid Hyperemesis Syndrome: A Rising Complication

Despite this trend, a strict criterion for the diagnosis of CHS is lacking. Early recognition of CHS is essential to prevent complications related to severe volume depletion. The recent body of research recognizes that patients with CHS impose a burden on the healthcare systems.

Help quitting cannabis

The role of cannabinoid (C.B.) receptors has enhanced our understanding of cannabis’s effects on inflammation, seizures, nausea, and appetite regulation 5,6,7. The ongoing cannabis legalization is expected to advance more research into its therapeutic potential. Ultimately, the treatment of any illness is the removal of precipitating factors, not merely the management of its symptoms. Patients are often diagnosed with the syndrome based on the way they treat their own symptoms.

Key points about cannabis hyperemesis syndrome

The clinical effects of volume depletion dominate complications related to CHS. Reports of severe volume depletion resulting in acute kidney injury and severe electrolyte disturbances with rhabdomyolysis have been reported in the literature 49. Severe and persistent vomiting can also lead to Mallory-Weiss tear 47. An intriguing point to keep in mind is that the Rome Substance abuse IV criteria include the phrase “resembling cyclical vomiting syndrome.” In that regard, it is important to distinguish between the two. These episodes of vomiting are often separated by weeks or months, and there is a return to baseline between episodes. Importantly, for the definition of cyclic vomiting syndrome, these episodes of vomiting cannot be attributed to other disorders.

Cannabis, Appetite, and Digestion: A Comprehensive Guide to Its Effects and Uses

Scientists do not know much about the function of the CB2 receptors. With the consumption of marijuana increasing due to the legalization of its recreational use in many states, doctors may receive more reports of side effects from marijuana use. It’s still not clear which of the more than 100 cannabinoids found in cannabis are responsible for CHS, but it’s thought that CBD could potentially be a contributor. Keep in mind none of these treatments will be effective if you continue using cannabis products. Research suggests that CHS is a permanent condition that can only be effectively treated by quitting cannabis. Continuing to use cannabis despite CHS can lead to potentially life threatening complications.

General Health

Contact your health care provider if you suspect you might have CHS or for information on treatment options for cannabis use disorder. Recent developments in cannabinoid research have led to the creation of novel modulators aimed at specifically targeting the CB1 receptors, which are integral to the psychoactive effects of cannabis. When these receptors are activated, they can influence mood and behavior, and in some individuals, may contribute to adverse psychological effects such as depression and suicidal ideation. This raises important concerns about the safety profile of future cannabinoid-based medications and therapies. As research progresses, careful consideration will be needed to balance therapeutic benefits with the potential for harmful side effects, particularly for vulnerable populations.

A recent study Omri Bar et al. showed 12 genes that were “Highly likely” (SCN4A, CACNA1A, CACNA1S, RYR2, TRAP1, MEFV) or “Likely” (SCN9A, TNFRSF1A, POLG, SCN10A, POGZ, TRPA1) to be CVS-related 48. As per this study, CVS is likely the result of a vicious cycle of elevated intracellular cations and mitochondrial dysfunction leading to cellular hyperexcitability 48. Both CVS and CHS are complex gastrointestinal conditions influenced by several entities, including genetic, environmental, and lifestyle factors.