Updated review finds haloperidol, benzodiazepines, and capsaicin cream most effective for cannabinoid hyperemesis syndrome

CHS does not reliably respond to standard IV antiemetics. Antipsychotics (particularly haloperidol), benzodiazepines, and capsaicin cream (a TRPV1 agonist) appear most effective for acute symptom management. Hot showers provide symptomatic relief. Complete resolution occurs only with cannabis cessation. CHS prevalence is expected to rise with increasing cannabis use and potency.

Updated clinical literature review covering CHS clinical features, differential diagnosis from cyclic vomiting syndrome, putative etiology, incidence, and treatment options including analgesics, antiemetics, antipsychotics, beta blockers, TRPV agonists, and capsaicin.

CHS is frequently unrecognized, leading to extensive unnecessary testing. Knowing which treatments work (and which standard approaches fail) can reduce patient suffering, healthcare costs, and diagnostic delays.

As cannabis potency and use continue increasing globally, CHS is becoming more common. The paradox of cannabis causing severe vomiting, when it is also used medically as an anti-nausea agent, continues to challenge both clinicians and patients.

Most treatment evidence comes from case reports and small case series. No randomized controlled trials of CHS treatments. Treatment recommendations are based on clinical experience rather than high-quality evidence. CHS diagnostic criteria still debated.