Bonnet Udo
Klinik für Seelische Gesundheit, Evangelisches Krankenhaus Castrop-Rauxel, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Grutholzallee 21, 44577, Castrop-Rauxel, Deutschland.
LVR-Universitätsklinik Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland.
Nervenarzt. 2025 Jul 21. doi: 10.1007/s00115-025-01864-0.
Until 25 years ago cyclic vomiting attacks under the chronic influence of cannabis were virtually unknown. Following the legalization of non-medical cannabis in North America and the associated increase in cannabis use, including high-potency strains, the number of patients there with cannabis-related cyclic vomiting is increasing. The ROME-IV criteria now define cannabis-induced cyclic vomiting as cannabinoid hyperemesis syndrome (CHS). This review aims to provide information about CHS, as an increase in cases is also to be expected in Germany following legalization.
Selective review article.
The CHS is most frequently registered in emergency departments. A clear differentiation between CHS and cyclic vomiting syndrome (CVS), in which one third of those affected also regularly use cannabis, is only possible by establishing full remission during a 6-12 month cannabis abstinence. Therefore, mixed forms of CVS and CHS are initially seen in emergency departments (suspected CHS), also with hidden life-threatening abdominal comorbidities. Severe vomiting can also lead to serious complications. The commonly used antiemetics often do not help. Hot showers and baths as well as i.m. haloperidol (5 mg) can provide acute relief from severe vomiting. Rubbing the abdomen with 0.075-0.1% capsaicin cream also has an antiemetic effect but less quickly.
In ROME-IV the CHS is nosologically considered a special variant of CVS. In particular, it is a specific cannabis-related, often severe physical disorder. As healing can only be achieved through sustained cannabis abstinence, suspected CHS in emergency departments is an interdisciplinary challenge for gastroenterology, neuropsychiatry and the addiction support system.
直到25年前，在大麻的长期影响下发生的周期性呕吐发作实际上并不为人所知。随着北美非医用大麻合法化以及大麻使用量的相应增加，包括高浓度品种，那里与大麻相关的周期性呕吐患者数量正在增加。罗马IV标准现在将大麻引起的周期性呕吐定义为大麻素呕吐综合征（CHS）。本综述旨在提供有关CHS的信息，因为在德国大麻合法化后预计病例数也会增加。
选择性综述文章。
CHS最常在急诊科被记录。只有在6至12个月的大麻戒断期内实现完全缓解，才能明确区分CHS和周期性呕吐综合征（CVS），其中三分之一的患者也经常使用大麻。因此，在急诊科最初会看到CVS和CHS的混合形式（疑似CHS），也伴有潜在的危及生命的腹部合并症。严重呕吐也可能导致严重并发症。常用的止吐药往往无效。热水淋浴和盆浴以及肌肉注射氟哌啶醇（5毫克）可迅速缓解严重呕吐。用0.075 - 0.1%辣椒素乳膏擦拭腹部也有止吐作用，但起效较慢。
在罗马IV中，CHS在疾病分类学上被认为是CVS的一种特殊变体。特别是，它是一种与大麻相关的特定的、通常严重的身体疾病。由于只有通过持续戒断大麻才能治愈，急诊科疑似CHS对胃肠病学、神经精神病学和成瘾支持系统来说是一个跨学科挑战。
