Droperidol plus diphenhydramine rapidly improved CHS symptoms in the emergency department

In 47 patients with suspected cannabinoid hyperemesis syndrome, droperidol plus diphenhydramine reduced nausea/vomiting scores from 8.3 to 1.4 and abdominal pain from 7.8 to 1.7 within 120 minutes.

Chopra, Quincy et al.·Open access emergency medicine : OAEM·2024·Moderate EvidenceProspective Cohort
RTHC-05208Prospective CohortModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
N=47

What This Study Found

Nausea/vomiting VAS scores dropped from 8.3 at baseline to 3.1 at 30 minutes and 1.4 at 120 minutes (both p<0.05). Abdominal pain VAS dropped from 7.8 to 3.6 at 30 minutes and 1.7 at 120 minutes (both p<0.05). Return ED visits within 7 days were 12.9%.

Key Numbers

47 patients. Nausea/vomiting: 8.3 to 3.1 at 30 min, 1.4 at 120 min. Abdominal pain: 7.8 to 3.6 at 30 min, 1.7 at 120 min. 12.9% returned to ED within 7 days. All changes significant at p<0.05.

How They Did This

Multicenter, prospective interventional study in EDs. 47 participants with suspected CHS received droperidol plus diphenhydramine. Nausea, vomiting, and abdominal pain measured on visual analogue scales at baseline, 30, and 120 minutes. 7-day ED return rate tracked.

Why This Research Matters

CHS is increasingly common and often poorly treated with standard antiemetics. This prospective data supports droperidol as an effective option, with rapid symptom improvement within 30 minutes that continued through 2 hours.

The Bigger Picture

The GRACE-4 guidelines recently recommended haloperidol/droperidol for CHS. This prospective study adds supporting evidence for droperidol specifically, with real-world data showing rapid, sustained symptom relief in a condition that can be resistant to conventional treatments.

What This Study Doesn't Tell Us

No control group or randomization. All participants received the intervention, so natural symptom resolution cannot be excluded. Relatively small sample. Suspected CHS diagnosis may include some misdiagnosed patients. Short follow-up.

Questions This Raises

  • ?How does droperidol compare to haloperidol for CHS in a head-to-head trial?
  • ?Is the 12.9% ED return rate lower than with standard antiemetics?
  • ?What is the optimal droperidol dose for CHS?

Trust & Context

Key Stat:
Nausea dropped from 8.3 to 1.4 within 120 minutes
Evidence Grade:
Prospective multicenter study with consistent results, but limited by lack of control group, small sample, and inability to blind participants to treatment.
Study Age:
Published in 2024 in Open Access Emergency Medicine.
Original Title:
Droperidol Plus Diphenhydramine for Symptom Improvement in Suspected Cannabinoid Hyperemesis Syndrome: A Prospective Cohort Study.
Published In:
Open access emergency medicine : OAEM, 16, 267-273 (2024)
Database ID:
RTHC-05208

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

What is the best treatment for cannabinoid hyperemesis syndrome?

This study found droperidol plus diphenhydramine rapidly improved nausea, vomiting, and abdominal pain in CHS patients. Recent guidelines also recommend haloperidol and topical capsaicin. Standard antiemetics like ondansetron are often less effective for CHS.

How quickly did symptoms improve?

Significant improvement occurred within 30 minutes, with nausea/vomiting scores dropping by more than half. By 2 hours, average symptoms had dropped from severe (8/10) to minimal (1-2/10).

Read More on RethinkTHC

Cite This Study

RTHC-05208·https://rethinkthc.com/research/RTHC-05208

APA

Chopra, Quincy; Peyko, Vincent; Lee, Jessica Annie; Puhalla, Leo; Gemmel, David J; Bolotin, Todd. (2024). Droperidol Plus Diphenhydramine for Symptom Improvement in Suspected Cannabinoid Hyperemesis Syndrome: A Prospective Cohort Study.. Open access emergency medicine : OAEM, 16, 267-273. https://doi.org/10.2147/OAEM.S473627

MLA

Chopra, Quincy, et al. "Droperidol Plus Diphenhydramine for Symptom Improvement in Suspected Cannabinoid Hyperemesis Syndrome: A Prospective Cohort Study.." Open access emergency medicine : OAEM, 2024. https://doi.org/10.2147/OAEM.S473627

RethinkTHC

RethinkTHC Research Database. "Droperidol Plus Diphenhydramine for Symptom Improvement in S..." RTHC-05208. Retrieved from https://rethinkthc.com/research/chopra-2024-droperidol-plus-diphenhydramine-for

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.