Department of Family and Community Medicine, Geriatrics and Palliative Care, Baycrest Health Sciences, University of Toronto, Toronto, Ontario, Canada.
University of Waterloo, Waterloo, Ontario, Canada.
Med Princ Pract. 2022;31(1):29-38. doi: 10.1159/000520417. Epub 2021 Nov 1.
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.
The aim of this study was to outline current treatments for the management of CHS.
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 2 separate reviewers.
The duration of cannabis administration ranged between 6 months to 11 years may precipitate symptoms of CHS. The Rome IV diagnostic criteria of CHS require cannabinoid use and persistence of N/V symptoms for at least the past 6 months. Cannabis cessation is noted to be the most successful management, but other treatments also demonstrated symptom relief; these include hot water hydrotherapy, topical capsaicin cream, haloperidol, droperidol, benzodiazepines, propranolol, and aprepitant administration.
More research on CHS is needed to enhance knowledge translation, education, and create awareness in the medical community on the side effects of cannabinoids and to propose the best treatment options.
目前有几种形式的大麻素被用于治疗恶心和呕吐(N/V)。在成年人和老年患者中,与慢性大麻使用相关的难治性 N/V 的新兴病例已被报道,命名为大麻相关性恶心呕吐综合征(CHS)。CHS 是一种导致长期使用大麻素的患者反复出现严重恶心和呕吐的疾病。
本研究旨在概述 CHS 的当前治疗方法。
使用 PubMed、Ovid MEDLINE、Cochrane Central、EMBASE 和 Google Scholar 进行系统评价。数据库用于搜索 2009 年 1 月至 2021 年 6 月发表的关于 CHS 的文章,共产生 225 个结果,其中 17 个被认为相关,并由 2 名独立评审员进行了评审。
大麻素的使用时间从 6 个月到 11 年不等,可能引发 CHS 的症状。CHS 的罗马 IV 诊断标准要求大麻素使用和 N/V 症状持续至少过去 6 个月。大麻素戒断被认为是最成功的治疗方法,但其他治疗方法也显示出症状缓解;这些包括热水水疗、局部辣椒素乳膏、氟哌啶醇、喷他佐辛、苯二氮䓬类药物、普萘洛尔和阿瑞匹坦的使用。
需要对 CHS 进行更多的研究,以加强知识转化、教育,并在医学界提高对大麻素副作用的认识,并提出最佳治疗方案。