A palliative care patient developed cannabinoid hyperemesis syndrome from prescribed nabilone

A 70-year-old cancer patient on long-term nabilone developed refractory nausea and vomiting that resolved only after stopping the drug, highlighting CHS risk even with prescribed synthetic cannabinoids.

Senderovich, Helen et al.·Oncology research and treatment·2022·Preliminary EvidenceCase Report
RTHC-04210Case ReportPreliminary Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

A 70-year-old palliative care patient with small-cell lung cancer who had used nabilone for 5 years developed refractory nausea and vomiting consistent with cannabinoid hyperemesis syndrome. Symptoms resolved after nabilone cessation.

Key Numbers

Patient used nabilone for 5 years. Dose increased from 0.5 to 2 mg. Nabilone discontinued after 7 weeks of refractory symptoms. Hot baths provided temporary relief. Pain was successfully managed with opioids and adjuvants after nabilone cessation.

How They Did This

Single case report of a palliative care patient. Nabilone dose had been incrementally increased from 0.5 to 2 mg over the disease course. CHS was suspected when increasing nabilone worsened rather than alleviated nausea and vomiting.

Why This Research Matters

This case demonstrates that CHS can occur with prescribed synthetic cannabinoids (not just recreational cannabis), a recognition gap that may lead clinicians to increase the very drug causing symptoms.

The Bigger Picture

As synthetic cannabinoids are increasingly prescribed in oncology and palliative care, awareness that they can cause the same hyperemesis syndrome as recreational cannabis is critical for avoiding a harmful cycle of dose escalation.

What This Study Doesn't Tell Us

Single case report, so the findings cannot be generalized. The diagnosis was clinical, without a definitive biomarker for CHS.

Questions This Raises

  • ?How common is CHS in patients on prescribed synthetic cannabinoids?
  • ?Is there a dose or duration threshold that predicts CHS onset?
  • ?Should nabilone prescribing guidelines include CHS monitoring?

Trust & Context

Key Stat:
5 years of nabilone use before CHS symptoms emerged
Evidence Grade:
Preliminary: single case report with no controlled comparison.
Study Age:
Published in 2022.
Original Title:
A Case Report on Cannabinoid Hyperemesis Syndrome in Palliative Care: How Good Intentions Can Go Wrong.
Published In:
Oncology research and treatment, 45(7-8), 438-443 (2022)
Database ID:
RTHC-04210

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 nabilone?

Nabilone is a synthetic cannabinoid prescribed for nausea, vomiting, and pain. It mimics THC but is a pharmaceutical product, not derived from the cannabis plant.

How was CHS recognized in this case?

The patient's nausea and vomiting worsened as the nabilone dose was increased, and hot baths provided temporary relief, both classic signs of CHS. Symptoms resolved completely after stopping nabilone.

Can CHS happen with any cannabinoid product?

This case suggests yes. CHS has been reported with recreational cannabis, medical cannabis, and now prescribed synthetic cannabinoids like nabilone.

Read More on RethinkTHC

Cite This Study

RTHC-04210·https://rethinkthc.com/research/RTHC-04210

APA

Senderovich, Helen; Waicus, Sarah. (2022). A Case Report on Cannabinoid Hyperemesis Syndrome in Palliative Care: How Good Intentions Can Go Wrong.. Oncology research and treatment, 45(7-8), 438-443. https://doi.org/10.1159/000524746

MLA

Senderovich, Helen, et al. "A Case Report on Cannabinoid Hyperemesis Syndrome in Palliative Care: How Good Intentions Can Go Wrong.." Oncology research and treatment, 2022. https://doi.org/10.1159/000524746

RethinkTHC

RethinkTHC Research Database. "A Case Report on Cannabinoid Hyperemesis Syndrome in Palliat..." RTHC-04210. Retrieved from https://rethinkthc.com/research/senderovich-2022-a-case-report-on

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.