A psychiatry case study showed intravenous haloperidol effectively treated cannabinoid hyperemesis syndrome
A case report of cannabinoid hyperemesis syndrome (CHS) required psychiatric consultation for diagnostic clarification and was successfully treated with intravenous haloperidol, highlighting an emerging role for psychiatrists in managing this cannabis-related disorder.
Quick Facts
What This Study Found
A patient with cannabinoid hyperemesis syndrome was initially misdiagnosed, requiring psychiatric consultation for proper identification.
CHS involves cyclic episodes of severe nausea and vomiting in chronic cannabis users, often with compulsive hot bathing for symptom relief. It resolves with cannabis cessation.
The patient was successfully treated with intravenous haloperidol, an antipsychotic not typically used for nausea but increasingly reported as effective for CHS.
The authors reviewed literature from emergency medicine, toxicology, and gastroenterology, including proposed diagnostic criteria and off-label treatment options for CHS, with emphasis on what consulting psychiatrists need to know about this condition.
Key Numbers
Treatment with intravenous haloperidol was effective. Specific dosing and timeline details were reported in the case.
How They Did This
Single case report with literature review. Included proposed diagnostic criteria for CHS and review of treatment options across multiple medical specialties.
Why This Research Matters
CHS is increasingly common as cannabis use rises, but it is frequently misdiagnosed because many clinicians (including psychiatrists) are unfamiliar with it. Patients may undergo extensive and unnecessary gastrointestinal workups before the correct diagnosis is reached.
The Bigger Picture
CHS challenges the perception that cannabis is without physical health consequences. As cannabis potency and daily use have increased, CHS has gone from a rare curiosity to a common emergency department presentation in areas with high cannabis use.
What This Study Doesn't Tell Us
Single case report. Haloperidol effectiveness for CHS is based on case reports and small series, not randomized trials. The mechanism by which haloperidol helps CHS is not fully understood.
Questions This Raises
- ?Is haloperidol more effective than traditional antiemetics for CHS?
- ?What percentage of chronic cannabis users eventually develop CHS?
- ?Could lower-potency cannabis products reduce CHS incidence?
Trust & Context
- Key Stat:
- IV haloperidol effectively resolved cannabinoid hyperemesis syndrome symptoms
- Evidence Grade:
- Preliminary. Single case report, though consistent with other case series reporting haloperidol effectiveness for CHS.
- Study Age:
- Published in 2018. CHS awareness and recognition has improved significantly since, with haloperidol becoming a more widely recognized treatment option.
- Original Title:
- Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.
- Published In:
- Journal of psychiatric practice, 24(1), 51-55 (2018)
- Authors:
- Kast, Kristopher A, Gershengoren, Liliya
- Database ID:
- RTHC-01713
Evidence Hierarchy
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 seen in chronic cannabis users involving repeated cycles of severe nausea, vomiting, and often abdominal pain. Many patients discover that hot showers or baths temporarily relieve symptoms. The only definitive treatment is stopping cannabis use.
Why would an antipsychotic help with vomiting?
Haloperidol acts on dopamine receptors in the brain, some of which are involved in the vomiting reflex. Cannabis affects the endocannabinoid system, which interacts with dopamine pathways. The exact mechanism for haloperidol effectiveness in CHS is still being studied, but it may work by resetting disrupted signaling in these pathways.
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Cite This Study
https://rethinkthc.com/research/RTHC-01713APA
Kast, Kristopher A; Gershengoren, Liliya. (2018). Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.. Journal of psychiatric practice, 24(1), 51-55. https://doi.org/10.1097/PRA.0000000000000279
MLA
Kast, Kristopher A, et al. "Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice.." Journal of psychiatric practice, 2018. https://doi.org/10.1097/PRA.0000000000000279
RethinkTHC
RethinkTHC Research Database. "Cannabinoid Hyperemesis Syndrome and the Consulting Psychiat..." RTHC-01713. Retrieved from https://rethinkthc.com/research/kast-2018-cannabinoid-hyperemesis-syndrome-and
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.