Cyclic vomiting syndrome shares features with cannabinoid hyperemesis but has deeper roots in migraine and mitochondrial disorders

Cyclic vomiting syndrome (CVS) is associated with migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, while cannabinoid hyperemesis syndrome is an increasingly recognized CVS-like illness linked to chronic cannabis use.

Hasler, William L et al.·Neurogastroenterology and motility·2019·Moderate EvidenceReview
RTHC-02066ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

CVS is characterized by severe episodic emesis with no randomized controlled trials to guide treatment. CHS is an increasingly recognized CVS-like condition associated with chronic cannabis use. Associations with migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric conditions provide pathophysiologic clues.

Key Numbers

No placebo-controlled randomized trials for CVS exist. Associated conditions: migraine, mitochondrial disorders, autonomic dysfunction, psychiatric comorbidities. A multicenter registry is proposed as the foundation for future research.

How They Did This

Expert review of CVS pathophysiology, comorbidities, and future research directions, proposing a multicenter registry approach to advance understanding and treatment development.

Why This Research Matters

CVS and CHS are frequently confused, with different treatment implications. Understanding their shared and distinct features helps clinicians distinguish between them and choose appropriate management. CHS resolves with cannabis cessation; CVS requires different approaches.

The Bigger Picture

As cannabis use increases, distinguishing CHS from CVS becomes more important. Both cause cyclic vomiting, but the treatments diverge completely. Building a registry and developing CVS-specific outcome measures would benefit patients with either condition.

What This Study Doesn't Tell Us

Review article without systematic methodology. CVS lacks standardized diagnostic criteria and outcome measures. The overlap between CVS and CHS is not fully characterized. Treatment recommendations based on limited clinical data.

Questions This Raises

  • ?What percentage of CVS cases are actually unrecognized CHS?
  • ?Could mitochondrial dysfunction explain why some cannabis users develop CHS while others don't?
  • ?Would biomarkers help distinguish CVS from CHS?

Trust & Context

Key Stat:
Zero randomized trials for cyclic vomiting syndrome despite increasing recognition
Evidence Grade:
Moderate: expert review covering pathophysiology and comorbidities, though based on limited clinical trial data.
Study Age:
Published in 2019.
Original Title:
Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.
Published In:
Neurogastroenterology and motility, 31 Suppl 2(Suppl 2), e13607 (2019)
Database ID:
RTHC-02066

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

What's the difference between CVS and CHS?

Both cause cyclic vomiting, but CHS is specifically associated with chronic cannabis use and resolves when cannabis stops. CVS occurs independently of cannabis use and is linked to migraine, mitochondrial disorders, and autonomic dysfunction.

How is cyclic vomiting syndrome treated?

No randomized controlled trials guide CVS treatment. Current recommendations are based on limited clinical data and are informed by associated conditions like migraine. A multicenter registry has been proposed to improve treatment development.

Read More on RethinkTHC

Cite This Study

RTHC-02066·https://rethinkthc.com/research/RTHC-02066

APA

Hasler, William L; Levinthal, David J; Tarbell, Sally E; Adams, Kathleen A; Li, B U K; Issenman, Robert M; Sarosiek, Irene; Jaradeh, Safwan S; Sharaf, Ravi N; Sultan, Shahnaz; Venkatesan, Thangam. (2019). Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.. Neurogastroenterology and motility, 31 Suppl 2(Suppl 2), e13607. https://doi.org/10.1111/nmo.13607

MLA

Hasler, William L, et al. "Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.." Neurogastroenterology and motility, 2019. https://doi.org/10.1111/nmo.13607

RethinkTHC

RethinkTHC Research Database. "Cyclic vomiting syndrome: Pathophysiology, comorbidities, an..." RTHC-02066. Retrieved from https://rethinkthc.com/research/hasler-2019-cyclic-vomiting-syndrome-pathophysiology

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.