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.
Quick Facts
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)
- Authors:
- Chopra, Quincy, Peyko, Vincent, Lee, Jessica Annie, Puhalla, Leo, Gemmel, David J, Bolotin, Todd
- Database ID:
- RTHC-05208
Evidence Hierarchy
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).
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Cite This Study
https://rethinkthc.com/research/RTHC-05208APA
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.