Droperidol Cuts ER Time by 36% for Cannabinoid Hyperemesis Syndrome
Emergency department patients with cannabinoid hyperemesis syndrome who received droperidol had 24% shorter stays, needed fewer total medications, and were 84% less likely to receive opioids.
Quick Facts
What This Study Found
Among 211 CHS encounters, droperidol use (36.5% of cases) was associated with a 24% reduction in length of stay (mean ratio 0.76, p = 0.01), 66% lower odds of receiving additional medications (OR 0.34, p < 0.001), and 84% lower odds of opioid use (OR 0.16, p < 0.001). Median stay was 409 minutes with droperidol vs. 641 minutes without.
Key Numbers
211 encounters; 158 unique patients; droperidol in 36.5% at median 1.25 mg; LOS 409 vs. 641 minutes; 84% reduction in opioid use (OR 0.16); 2 mild adverse reactions.
How They Did This
Retrospective study of 211 CHS encounters among 158 unique patients at two tertiary academic emergency departments in Atlanta from March-August 2024. Patients stratified by droperidol use with adjusted analyses.
Why This Research Matters
Cannabinoid hyperemesis syndrome is an increasingly common ER presentation with no established standard treatment. Finding an effective first-line therapy that also reduces opioid use addresses two problems at once.
The Bigger Picture
As cannabis use increases, so do CHS presentations. Emergency departments currently use a grab bag of medications. Droperidol, an older antiemetic that fell out of favor due to QTc concerns, may be finding new relevance in the cannabis era.
What This Study Doesn't Tell Us
Retrospective design with potential selection bias in who received droperidol. Single health system in one city. CHS diagnosis based on ICD codes and chart review. Cannot establish causation.
Questions This Raises
- ?Would a randomized trial confirm droperidol as first-line for CHS?
- ?What is the optimal droperidol dosing regimen for CHS?
Trust & Context
- Key Stat:
- 409 vs. 641 minutes ER stay with droperidol
- Evidence Grade:
- Retrospective cohort from two academic EDs with adjusted analyses, but without randomization or blinding.
- Study Age:
- 2025 publication with data from March-August 2024
- Original Title:
- Droperidol is associated with reduced length of stay in the treatment of cannabinoid hyperemesis syndrome.
- Published In:
- Clinical toxicology (Philadelphia, Pa.), 63(8), 550-555 (2025)
- Database ID:
- RTHC-06810
Evidence Hierarchy
Frequently Asked Questions
What is the best treatment for cannabinoid hyperemesis syndrome in the ER?
This study found droperidol (a potent antiemetic) was associated with 24% shorter ER stays and 84% fewer opioid prescriptions compared to standard care. The authors suggest it may be considered as a first-line treatment, though randomized trials are still needed.
Does droperidol have side effects when used for CHS?
In this study of 211 encounters, only 2 mild adverse drug reactions occurred in the droperidol group. The typical dose was 1.25 mg. Historically, droperidol raised QTc prolongation concerns, but modern usage at lower doses appears well-tolerated.
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Cite This Study
https://rethinkthc.com/research/RTHC-06810APA
Kelly, Geoffrey S; Meeks, Gavin; McCoul, Bradley; Doshi, Vidhi K; Moran, Tim P. (2025). Droperidol is associated with reduced length of stay in the treatment of cannabinoid hyperemesis syndrome.. Clinical toxicology (Philadelphia, Pa.), 63(8), 550-555. https://doi.org/10.1080/15563650.2025.2516128
MLA
Kelly, Geoffrey S, et al. "Droperidol is associated with reduced length of stay in the treatment of cannabinoid hyperemesis syndrome.." Clinical toxicology (Philadelphia, 2025. https://doi.org/10.1080/15563650.2025.2516128
RethinkTHC
RethinkTHC Research Database. "Droperidol is associated with reduced length of stay in the ..." RTHC-06810. Retrieved from https://rethinkthc.com/research/kelly-2025-droperidol-is-associated-with
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.