Best Treatments for Cannabinoid Hyperemesis Syndrome
Capsaicin cream, antipsychotics, and benzodiazepines appeared more effective for cannabinoid hyperemesis syndrome than commonly used anti-nausea medications like ondansetron.
Quick Facts
What This Study Found
Across 34 articles and 63 individual cases of CHS, capsaicin cream, antipsychotics, and benzodiazepines were reported to improve symptoms more effectively than standard anti-emetics such as promethazine, ondansetron, and metoclopramide. The authors proposed a treatment algorithm for consultation-liaison psychiatrists.
Key Numbers
34 eligible articles with 63 individual cases reviewed. Capsaicin cream, antipsychotics, and benzodiazepines outperformed standard anti-emetics. The proposed algorithm provides a stepwise treatment approach.
How They Did This
Systematic review following PRISMA guidelines, searching PubMed, PsychINFO, Embase, and Web of Science from inception to July 2021. Included cases where patient-level treatment data was available. Beneficial treatment defined as resolution of nausea, vomiting, and compulsive hot showering.
Why This Research Matters
CHS is increasingly common and notoriously resistant to standard anti-emetics. Having an evidence-based treatment algorithm could reduce emergency department visits and hospital stays for affected patients.
The Bigger Picture
The finding that standard anti-emetics are relatively ineffective for CHS explains why many patients cycle through multiple ER visits before finding relief. The capsaicin mechanism (TRPV1 receptor modulation) directly addresses the hypothesized pathophysiology.
What This Study Doesn't Tell Us
Evidence base consists entirely of case reports and case series, the lowest level of clinical evidence. Search only through July 2021 misses recent literature. Publication bias likely favors successful treatments. No randomized controlled trials available.
Questions This Raises
- ?Would a randomized controlled trial of capsaicin versus ondansetron in CHS be feasible?
- ?Can the proposed treatment algorithm reduce repeat ER visits for CHS patients?
Trust & Context
- Key Stat:
- Capsaicin, antipsychotics, and benzodiazepines outperformed standard anti-emetics across 63 CHS cases
- Evidence Grade:
- Systematic review methodology is strong, but the underlying evidence consists entirely of case reports and series with no controlled trials.
- Study Age:
- 2025 publication with literature search through July 2021.
- Original Title:
- Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists.
- Published In:
- General hospital psychiatry, 97, 185-191 (2025)
- Authors:
- Hsu, Jennifer(2), Kashyap, Saurabh(2), Hurd, Cheryl, McCormack, Lauren, Herrmann, Zachary, Schwartz, Ann C, Jackson, Joshua, DeMoss, Dustin
- Database ID:
- RTHC-06682
Evidence Hierarchy
Read More on RethinkTHC
- 420-sober-survival-guide
- CBD-oil-quality-guide
- CBT-cannabis-recovery
- anxiety-medication-after-quitting-weed
- cannabis-chemotherapy-nausea
- cannabis-chronic-pain-research
- cannabis-epilepsy-CBD-Epidiolex
- cannabis-relapse-cycle-pattern
- cbd-anxiety-research-evidence
- cbd-for-weed-withdrawal
- cbd-vs-thc-difference
- cold-turkey-vs-taper-quit-weed
- dating-sober-after-quitting-weed
- exercise-quitting-weed-anxiety-brain
- grieving-quitting-weed-loss
- help-someone-quit-weed
- how-to-quit-weed
- journaling-weed-withdrawal
- marijuana-anonymous-SMART-recovery-compare
- medical-benefits-of-cannabis
- meditation-mindfulness-weed-withdrawal
- partner-still-smokes-weed
- partner-still-smokes-weed-quitting
- pink-cloud-sobriety-cannabis
- quit-weed-cold-turkey
- quit-weed-or-cut-back-which-is-better
- quit-weed-regret-went-back
- quitting-weed-20s
- quitting-weed-30s
- quitting-weed-after-years
- quitting-weed-before-surgery
- quitting-weed-during-crisis-divorce-job-loss
- quitting-weed-exercise
- quitting-weed-grief-loss-coping
- quitting-weed-legal-state
- quitting-weed-medication-interactions
- quitting-weed-pregnancy
- quitting-weed-pregnant
- quitting-weed-success-stories
- quitting-weed-triggers-environment
- relapsed-smoking-weed-what-to-do
- relapsed-weed
- seniors-older-adults-cannabis-risks-medications
- should-i-quit-weed
- sober-music-festival-concert-without-weed
- supplements-weed-withdrawal
- telling-friends-quitting-weed
- weed-breastfeeding-THC-breast-milk
- weed-relapse-prevention-plan
- weed-relapse-why-it-happens
- weed-ritual-replacement
- weed-ruined-relationships
- weed-social-media-triggers-quit
Cite This Study
https://rethinkthc.com/research/RTHC-06682APA
Hsu, Jennifer; Kashyap, Saurabh; Hurd, Cheryl; McCormack, Lauren; Herrmann, Zachary; Schwartz, Ann C; Jackson, Joshua; DeMoss, Dustin. (2025). Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists.. General hospital psychiatry, 97, 185-191. https://doi.org/10.1016/j.genhosppsych.2025.10.012
MLA
Hsu, Jennifer, et al. "Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists.." General hospital psychiatry, 2025. https://doi.org/10.1016/j.genhosppsych.2025.10.012
RethinkTHC
RethinkTHC Research Database. "Treatment of cannabinoid hyperemesis syndrome: A systematic ..." RTHC-06682. Retrieved from https://rethinkthc.com/research/hsu-2025-treatment-of-cannabinoid-hyperemesis
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.