Haloperidol Successfully Treated Cannabinoid Hyperemesis Syndrome in the Emergency Department

A patient with cannabinoid hyperemesis syndrome, which had not responded to conventional anti-nausea medications, improved significantly after receiving haloperidol in the emergency department.

Hickey, Jami L et al.·The American journal of emergency medicine·2013·Preliminary EvidenceCase Report
RTHC-00688Case ReportPreliminary Evidence2013RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

A patient with cannabinoid hyperemesis syndrome (CHS), characterized by cyclical vomiting in the setting of chronic cannabis use, was treated with haloperidol in the emergency department. The condition had been unresponsive to conventional antiemetic medications.

Patients with CHS typically report that only compulsive bathing and hot showers provide relief, and the condition frequently requires hospital admission due to intractable vomiting. In this case, haloperidol produced significant improvement, suggesting a potential pharmacological treatment option for a condition with very limited treatment options.

Key Numbers

1 patient with CHS. Unresponsive to conventional antiemetics. Significant improvement with haloperidol. CHS characterized by cyclical vomiting in chronic cannabis users.

How They Did This

Single case report of CHS treated with haloperidol in an emergency department setting.

Why This Research Matters

CHS is increasingly recognized as cannabis use grows, and current treatment options are limited. If haloperidol consistently works, it could transform ER management of CHS from prolonged observation and admission to rapid treatment and discharge.

The Bigger Picture

This case report was among the first to suggest dopamine antagonists as a CHS treatment strategy. Subsequent reports and small studies have supported this approach, with haloperidol and droperidol emerging as effective options. The mechanism may involve dopamine's role in the vomiting reflex and temperature regulation.

What This Study Doesn't Tell Us

Single case report provides the lowest level of clinical evidence. Spontaneous resolution cannot be excluded. The dose and timing of haloperidol were not detailed in the abstract. No comparison to other treatments. Long-term outcome was not reported.

Questions This Raises

  • ?What is the optimal haloperidol dose for CHS?
  • ?Would other dopamine antagonists work equally well?
  • ?Does haloperidol address the underlying CHS mechanism or just mask symptoms?
  • ?What is the relapse rate if cannabis use continues?

Trust & Context

Key Stat:
Haloperidol worked when conventional antiemetics failed for CHS
Evidence Grade:
Single case report; preliminary evidence but has been supported by subsequent studies.
Study Age:
Published in 2013. Haloperidol has since gained wider recognition as a CHS treatment in emergency settings.
Original Title:
Haloperidol for treatment of cannabinoid hyperemesis syndrome.
Published In:
The American journal of emergency medicine, 31(6), 1003.e5-6 (2013)
Database ID:
RTHC-00688

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

Describes what happened to one person or a small group.

What do these levels mean? →

Frequently Asked Questions

What is cannabinoid hyperemesis syndrome?

CHS is a condition where chronic, heavy cannabis use causes cyclical episodes of severe nausea and vomiting that do not respond to typical anti-nausea medications. Patients often find that only very hot showers or baths provide temporary relief. The only proven long-term treatment is stopping cannabis use.

Why does haloperidol work for CHS?

The exact mechanism is not fully understood. Haloperidol blocks dopamine receptors, and dopamine is involved in both the vomiting reflex and temperature regulation (which may explain why hot showers help). By blocking dopamine, haloperidol may address the same pathway that is disrupted in CHS. This case was one of the first to report this treatment approach.

Read More on RethinkTHC

Cite This Study

RTHC-00688·https://rethinkthc.com/research/RTHC-00688

APA

Hickey, Jami L; Witsil, Joanne C; Mycyk, Mark B. (2013). Haloperidol for treatment of cannabinoid hyperemesis syndrome.. The American journal of emergency medicine, 31(6), 1003.e5-6. https://doi.org/10.1016/j.ajem.2013.02.021

MLA

Hickey, Jami L, et al. "Haloperidol for treatment of cannabinoid hyperemesis syndrome.." The American journal of emergency medicine, 2013. https://doi.org/10.1016/j.ajem.2013.02.021

RethinkTHC

RethinkTHC Research Database. "Haloperidol for treatment of cannabinoid hyperemesis syndrom..." RTHC-00688. Retrieved from https://rethinkthc.com/research/hickey-2013-haloperidol-for-treatment-of

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.