Cannabis Appetite Research

Medical Use of Cannabinoids.

Fraguas-Sánchez, Ana Isabel · 2018

This extensive review covered the therapeutic landscape of cannabinoids across dozens of medical conditions. Six cannabinoid medications had already received regulatory approval: nabilone and dronabinol capsules for chemotherapy nausea and vomiting, dronabinol capsules and oral solution for anorexia, THC:CBD oromucosal spray (Sativex) for MS-related spasticity and cancer pain, and CBD oral solution (Epidiolex) for Dravet and Lennox-Gastaut epilepsy syndromes. Beyond approved uses, the review found evidence supporting potential applications in inflammatory and neuropathic pain, various cancer types (brain, breast, prostate), neurodegenerative diseases (Parkinson's, Huntington's, Alzheimer's), PTSD and anxiety disorders, irritable bowel syndrome, eye diseases, and substance abuse disorders (particularly alcohol and opioid). The endocannabinoid system's involvement in energy balance, appetite, blood pressure, pain modulation, nausea, memory, learning, and immune response explains the breadth of potential therapeutic applications..

MECHANISMS IN ENDOCRINOLOGY: Endocannabinoids and metabolism: past, present and future.

Simon, Vincent · 2017

This review charted the evolution of understanding about the endocannabinoid system (ECS) and metabolism.

Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review.

Sorensen, Cecilia J · 2017

This extensive systematic review analyzed 2,178 articles, ultimately including 183 studies with cumulative case data.

Cannabis use before and after metabolic and bariatric surgery and its association with alcohol use.

Vanderziel, Alyssa · 2026

Post-bariatric surgery cannabis use rose from roughly 10.5% to 16%, a 52.4% relative increase.

Cannabis Intoxication Does Not Impact Nutritional Status in Patients with Small Burns.

Wang, Sarah · 2026

Cannabis-positive burn patients showed no significant differences in admission prealbumin (18.8 vs 19.2, p=0.804), admission albumin (3.9 vs 4.0, p=0.375), or time to peak nutritional markers compared to matched controls.

Endocannabinoid signaling in stress, nausea, and vomiting.

DeVuono, Marieka V · 2025

The endocannabinoid system normally regulates nausea, vomiting, and anxiety.

Cannabis use and binge eating among young adults: The role of depressive symptoms.

Elran-Barak, Roni · 2025

Female cannabis users had a 24% binge eating rate compared to 13% among non-users (p<0.001).

Coordinated epigenetic dysregulation of CNR1 and FAAH genes drives endocannabinoid system dysfunction in anorexia nervosa.

Gilardini, Federica · 2025

A novel bidirectional epigenetic dysregulation was discovered: CNR1 (cannabinoid receptor 1) promoter hypermethylation coupled with FAAH (endocannabinoid-degrading enzyme) promoter hypomethylation.

Cannabis use patterns and association with hyperemesis: A comprehensive review.

Hasler, William L · 2025

This comprehensive review found that 40-80% of cyclic vomiting syndrome (CVS) patients use cannabis.

Cannabis produces acute hyperphagia in humans and rodents via increased reward valuation for, and motivation to, acquire food.

Hume, Catherine · 2025

Vaporized cannabis acutely and robustly increased energy intake in humans (within 30 minutes, regardless of dose or gender) and rats (within 60 minutes, regardless of macronutrient content, satiation, or sex).

Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories.

Moore, Brianna F · 2025

Among 128 mother-child pairs, prenatal THC exposure (12% of children) was associated with 95g less fat mass and 2.1% lower adiposity at birth, followed by rapid postnatal growth (0.42 BMI z-score increase per square root year).

Characterization of Patients With Symptoms of Gastroparesis Having Frequent Emergency Department Visits and Hospitalizations.

Parkman, Henry P · 2025

Cannabis use was independently associated with both ED visits and hospitalizations in gastroparesis patients, even after controlling for other factors.

Cannabinoid Hyperemesis Syndrome: A Rising Complication.

Peles, Saar · 2025

CHS is characterized by cyclical nausea, vomiting, and abdominal pain in chronic cannabis users, paradoxically caused by a drug known for anti-nausea effects.

Cannabinoid Hyperemesis Syndrome in Adolescents: A Narrative Review.

Pietrantoni, Camilla · 2025

CHS is increasingly being diagnosed in adolescents despite limited data in the pediatric population.

Weight loss outcomes are not compromised in bariatric patients using cannabis.

Huang, Estella Y · 2023

One of the most common concerns about cannabis use after bariatric surgery is the 'munchies' — cannabis stimulates appetite, and the whole point of bariatric surgery is to restrict eating.

Role of the CB2 Cannabinoid Receptor in the Regulation of Food Intake: A Systematic Review.

Rodríguez-Serrano, Luis Miguel · 2023

CB2 receptors in brain reward areas modulate food intake.

Targeting the Endocannabinoid CB1 Receptor to Treat Body Weight Disorders: A Preclinical and Clinical Review of the Therapeutic Potential of Past and Present CB1 Drugs.

Murphy, Thomas · 2020

Rimonabant (CB1 inverse agonist) effectively produced weight loss but was withdrawn due to depression and suicidal ideation.

Cannabis hyperemesis syndrome: an update on the pathophysiology and management.

Perisetti, Abhilash · 2020

CHS is characterized by cyclic nausea and vomiting worsened by cannabis, with compulsive hot bathing/showers for relief.

Patterns of Cannabis Use in Patients With Cyclic Vomiting Syndrome.

Venkatesan, Thangam · 2020

41% of CVS patients used cannabis, with 21% using regularly (4+ times/week).

Impact of Medical Cannabis on Patient-Reported Symptoms for Patients With Cancer Enrolled in Minnesota's Medical Cannabis Program.

Anderson, Susan P · 2019

Significant reductions were found across all 8 symptoms (anxiety, appetite loss, depression, sleep disturbance, fatigue, nausea, pain, and vomiting) within 4 months of starting medical cannabis.

Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults.

Aziz, Imran · 2019

FNVDs affected 2.2% of the population.

Recent trends in cyclic vomiting syndrome-associated hospitalisations with liberalisation of cannabis use in the state of Colorado.

Bhandari, Sanjay · 2019

CVS hospitalizations increased 46% from 806 (2010) to 1,180 (2014).

Cannabis-related emergencies in children and teens.

Chen, Yih-Chieh · 2019

Cannabis-related pediatric ED visits are rising with changing legislation.

Cannabinoid hyperemesis syndrome: a review of the literature.

Deceuninck, Eleonore · 2019

CHS manifests as incoercible cyclical vomiting, diffuse abdominal pain, and compulsive hot showering in chronic cannabis users.

Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions.

Hasler, William L · 2019

CVS is characterized by severe episodic emesis with no randomized controlled trials to guide treatment.

Opportunities for cannabis in supportive care in cancer.

Kleckner, Amber S · 2019

The review found reasonable evidence to consider cannabis for nausea/vomiting, appetite loss, and pain as supplemental treatment.

The utility of droperidol in the treatment of cannabinoid hyperemesis syndrome.

Lee, Carl · 2019

Droperidol-treated CHS patients had significantly shorter hospital stays (6.7 vs.

Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period.

Madireddy, Sowmya · 2019

Hospitalizations for intractable vomiting with CUD showed a significant increasing trend from 2010-2014 (N=9,601 total).

Cannabinoids: the lows and the highs of chemotherapy-induced nausea and vomiting.

Mortimer, Toni Leigh · 2019

Cannabinoids reduce CINV primarily by inhibiting serotonin release from enterochromaffin cells in the small intestine, disrupting the vomiting reflex.

Role of Cannabinoid Receptor Type 1 in Insulin Resistance and Its Biological Implications.

Nagappan, Arulkumar · 2019

CB1 receptor activation in the liver promotes insulin resistance via increased energy intake/storage, impaired glucose and lipid metabolism, enhanced oxidative stress, and inflammatory responses.

Overcoming the Psychiatric Side Effects of the Cannabinoid CB1 Receptor Antagonists: Current Approaches for Therapeutics Development.

Nguyen, Thuy · 2019

Rimonabant demonstrated effectiveness for treating obesity and smoking cessation but was withdrawn from the European market due to psychiatric side effects.

Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer.

Badowski, Melissa E · 2018

Researchers reviewed the evidence for dronabinol, a synthetic form of THC, in treating anorexia and weight loss associated with HIV/AIDS and cancer.

Effects of cannabis use on body mass, fasting glucose and lipids during the first 12 months of treatment in schizophrenia spectrum disorders.

Scheffler, F · 2018

There was a significant group-by-time interaction (p=0.002): cannabis-negative patients showed greater BMI increases over 12 months than cannabis-positive patients.

Concise review of the management of iatrogenic emesis using cannabinoids: emphasis on nabilone for chemotherapy-induced nausea and vomiting.

Pergolizzi, Joseph V · 2017

The review examined nabilone's pharmacology and clinical trial evidence for treating chemotherapy-induced nausea and vomiting (CINV).

Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review.

Richards, John R · 2017

The systematic review analyzed 63 eligible articles covering 205 CHS patients.

Cannabis Use in Palliative Oncology: A Review of the Evidence for Popular Indications.

Turgeman, Ilit · 2017

The review assessed cannabis and cannabinoid use across the spectrum of palliative care needs in cancer patients. The best-established indications were chemotherapy-induced nausea and vomiting (CINV), where synthetic cannabinoids like nabilone and dronabinol have been approved for decades, and cancer-related pain, where cannabis showed benefit particularly for pain not adequately controlled by opioids alone. Emerging evidence supported use for anorexia/cachexia (cancer-related weight loss), insomnia, and anxiety, though clinical trial data for these indications was limited.

Decision-Making Does not Moderate the Association between Cannabis Use and Body Mass Index among Adolescent Cannabis Users.

Ross, J Megan · 2016

In a sample of 238 adolescent cannabis users aged 14 to 18 (77% Hispanic), researchers found that greater lifetime cannabis use was associated with higher body mass index and a greater likelihood of being classified as overweight or obese. The researchers hypothesized that decision-making abilities might moderate this relationship, since impulsive decision-making could lead to both more cannabis use and poorer dietary choices.

Marijuana Use and Type 2 Diabetes Mellitus: a Review.

Sidney, Stephen · 2016

This review examined the paradoxical relationship between cannabis use and diabetes.

Cannabis in cancer care.

Abrams, D I · 2015

The review covers established and emerging roles of cannabis in cancer care.

Dissecting the cannabinergic control of behavior: The where matters.

Busquets-Garcia, Arnau · 2015

This review examined how the location of CB1 receptors across different brain cell types and subcellular compartments determines the specific behavioral effects of cannabinoids.

Cannabinoids for medical use: A systematic review and meta-analysis

Whiting, Penny F. · 2015

Across 79 RCTs, cannabinoids were linked to better symptom outcomes than placebo for several indications, but effects were often small and not consistently statistically significant across trials.

Neural effects of cannabinoid CB1 neutral antagonist tetrahydrocannabivarin on food reward and aversion in healthy volunteers.

Tudge, Luke · 2014

Twenty healthy volunteers received either 10mg THCV or placebo in a double-blind crossover design.

Metabolic effects of chronic cannabis smoking.

Muniyappa, Ranganath · 2013

Thirty chronic cannabis smokers (median 9.5 years use, 6 joints/day) were compared to 30 matched controls.

The impact of marijuana use on glucose, insulin, and insulin resistance among US adults.

Penner, Elizabeth A · 2013

Using NHANES data from 2005-2010, researchers compared metabolic markers between 579 current marijuana users, 1,975 past users, and never-users.

Cannabinoid hyperemesis syndrome.

Galli, Jonathan A · 2011

The review synthesized existing knowledge about cannabinoid hyperemesis syndrome (CHS), describing a paradox: cannabis is well-established as an anti-emetic, yet chronic use could cause severe cyclic vomiting. The clinical course was divided into three phases.

Cannabinoid-Induced Hyperemesis: A Conundrum-From Clinical Recognition to Basic Science Mechanisms.

Darmani, Nissar A · 2010

Cannabinoids are clinically used as anti-nausea medications (preventing chemotherapy-induced vomiting through CB1 receptor stimulation), making the recently recognized cannabinoid hyperemesis syndrome (CHS) a paradox. CHS is characterized by repeated cyclical vomiting and compulsive hot water bathing in chronic cannabis users.

A critical review of the cannabinoid receptor as a drug target for obesity management.

Akbas, F · 2009

This critical review assessed how close CB1 cannabinoid receptor antagonists were to being ideal anti-obesity drugs. The mechanisms were sound: CB1 antagonists reduced food intake centrally (brain) and may increase energy expenditure peripherally (thermogenesis in animal studies). However, the clinical reality was disappointing.

The future of endocannabinoid-oriented clinical research after CB1 antagonists.

Le Foll, Bernard · 2009

Rimonabant, the first clinically available CB1 receptor antagonist, showed promise for treating obesity, metabolic syndrome, and potentially drug addiction.

Endocannabinoids and the neurochemistry of gluttony.

Kirkham, Tim · 2008

This brief review outlined how the endocannabinoid system drives overeating through two complementary mechanisms. First, endocannabinoids acting at CB1 receptors in the brain increase appetite by enhancing both food craving (wanting) and food enjoyment (liking).

Endocannabinoid dysregulation in the pancreas and adipose tissue of mice fed with a high-fat diet.

Starowicz, Katarzyna M · 2008

Researchers fed mice standard or high-fat diets for up to 14 weeks and mapped the endocannabinoid system in their pancreatic and fat tissues. In the pancreas, they found that CB1 receptors and endocannabinoid-producing enzymes were primarily located in alpha cells (which make glucagon), while degrading enzymes were in beta cells (which make insulin).

Pharmacotherapeutic targeting of the endocannabinoid signaling system: drugs for obesity and the metabolic syndrome.

Vemuri, V Kiran · 2008

This review detailed the pharmacological rationale for targeting the endocannabinoid system in obesity and metabolic syndrome. The endocannabinoid system promotes food intake (through brain CB1 receptors) and energy storage as fat (through peripheral CB1 receptors).

Targeted modulators of the endogenous cannabinoid system: future medications to treat addiction disorders and obesity.

Janero, David R · 2007

This review outlined how the endocannabinoid system regulates reward-driven behaviors that underlie both addiction and obesity.

Rimonabant: a cannabinoid receptor type 1 blocker for management of multiple cardiometabolic risk factors.

Gelfand, Eli V · 2006

This review from the Journal of the American College of Cardiology summarized clinical trial evidence for rimonabant, the first selective CB1 cannabinoid receptor blocker developed for cardiometabolic risk management. Across four large trials, rimonabant 20 mg daily produced greater weight loss and waist circumference reduction compared to placebo after one year.

The emerging role of the endocannabinoid system in endocrine regulation and energy balance.

Pagotto, Uberto · 2006

This comprehensive review published in Endocrine Reviews detailed the endocannabinoid system's emerging role in regulating hormonal function.

Nicotine and cannabinoids: parallels, contrasts and interactions.

Viveros, Maria-Paz · 2006

This review examined the pharmacological interactions between nicotine and cannabis, two drugs increasingly used in combination, especially by adolescents and young adults. Animal studies suggested that the reinforcing effects of both drugs may be enhanced by joint consumption.

Cannabinoids.

Grotenhermen, Franjo · 2005

This comprehensive review covered 15 years of research since the discovery of the endocannabinoid system.

Endocannabinoids in the regulation of appetite and body weight.

Kirkham, T C · 2005

This review compiled evidence on the endocannabinoid system's role in appetite and body weight regulation.

The endocannabinoid system and the treatment of obesity.

Pagotto, Uberto · 2005

This review detailed how the endocannabinoid system contributes to obesity through two parallel mechanisms.

Cannabinoids and the regulation of ingestive behaviour.

Vickers, S P · 2005

This review compiled evidence on how cannabinoids regulate eating behavior, covering both exogenous (plant-derived) and endogenous cannabinoids.

Cannabinoids on the brain.

Irving, Andrew J · 2002

The review synthesized research on how cannabinoids interact with the brain across multiple systems.

Cancer cachexia and cannabinoids.

Gorter, R W · 1999

Anorexia and cachexia (severe weight loss) are diagnosed in more than two-thirds of cancer patients with advanced disease and independently increase illness and death risk.

Medicinal applications of delta-9-tetrahydrocannabinol and marijuana.

Voth, E A · 1997

Following the passage of ballot initiatives in California and Arizona making marijuana accessible to patients, the authors reviewed all relevant research from 1975 to 1996 on medical applications of THC and marijuana. The evidence supported selective use of pure THC preparations for two conditions: nausea associated with cancer chemotherapy and appetite stimulation.

Latent profiles of cannabis use patterns and associations with eating pathology outcomes.

Stanley, Taylor B · 2026

Four profiles of cannabis users were identified: infrequent/low-risk, intense/mild-risk, high-risk coping with strong eating changes, and frequent/mild-risk.

Pilot Randomized Trial of Medical Cannabis to Reduce Symptom Burden in Patients With Newly Diagnosed Advanced Pancreatic Cancer (CanPan).

Zylla, Dylan · 2026

The trial met all prespecified feasibility benchmarks: 74% enrollment (goal 20%), 81% compliance (goal 60%), and 75% outcome completion (goal 50%).

Targeting the endocannabinoid/paracannabinoid systems in binge eating behavior: Efficacy of dual ligands in a preclinical model.

de Ceglia, Marialuisa · 2025

OLHHA (CB1 antagonist/PPAR-alpha agonist) at 0.3 mg/kg and OLS (PPAR-alpha/TRPV1 agonist) at 6 mg/kg reduced aberrant palatable food consumption during binge eating tests.

Obesogenic diet impairs memory consolidation via the hippocampal endocannabinoid system.

Ducourneau, Eva-Gunnel · 2025

Obesogenic diet consumption impaired long-term object recognition memory, and this was prevented by post-training CB1 receptor blockade, which also normalized hippocampal overactivation.

Distinct Adipocyte Responses to Δ9-Tetrahydrocannabinol (THC) Exposure Govern Hepatic Lipid Accumulation in an Obesogenic Setting.

Eitan, Adi · 2025

THC produced a biphasic response in mature fat cells: initially increasing free fatty acid release, then improving fat storage by day 18 with smaller lipid droplets and enhanced lipid handling.

Clinical Characteristics and Associated Factors in Mexican Patients With Cyclic Vomiting Syndrome and Cannabinoid Hyperemesis Syndrome.

Felix-Tellez, Francisco A · 2025

In this 46-patient Mexican study, cannabinoid hyperemesis syndrome (CHS) patients had higher tobacco use (50% vs 27%) and risky alcohol use (31% vs 0%) compared to cyclic vomiting syndrome (CVS) patients, though both groups had similar hospitalization rates..

An Adolescent Female With Disordered Eating and Cannabis Use Found to Have Acute Intermittent Porphyria.

Gertz, Brooke · 2025

This case report describes a diagnostic near-miss that highlights an important clinical lesson: when a patient's symptoms overlap with known cannabis effects, the cannabis use can become a cognitive shortcut that prevents clinicians from looking further. A 15-year-old girl presented to the emergency department with nausea, vomiting, and decreased appetite.

Cannabinoid hyperemesis syndrome in pregnancy: a case series and review.

Hanley, Sarah · 2025

Two cases of CHS in pregnancy were described.

Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department.

Heidish, Ryan · 2025

In a pilot study of 18 CHS patients (mean age 34, 56% female), pain severity was high (mean triage score 6.4/10) and pain significantly interfered with daily activities (PROMIS T-score 62.2).

Wernicke's Encephalopathy Secondary to Cannabis Hyperemesis Syndrome.

Kattamuri, Lakshmi · 2025

This case describes an uncommon but serious cascade: heavy cannabis use triggered cannabinoid hyperemesis syndrome (CHS), which caused weeks of persistent vomiting, which led to severe thiamine (vitamin B1) deficiency, which ultimately caused Wernicke's encephalopathy—a neurological emergency typically associated with alcoholism. The patient, a woman in her 20s, presented after eight weeks of nausea and vomiting.

Cannabinoid-Induced Hyperphagia is Mediated by Increased Meal Frequency and the Orexin-1 Receptor in Male Rats.

Lord, Magen N · 2025

Orally consumed cannabinoid edibles caused overeating by increasing meal frequency, not meal size.

Benefits and Burdens of Vaporized Botanical Cannabis Flower Bud for Cancer-Related Anorexia: A Qualitative Study of the Experiences of People with Advanced Cancer Enrolled as Inpatients in a Phase I/IIb Clinical Trial and Their Family Carers.

Luckett, Tim · 2025

This qualitative study interviewed 10 advanced cancer patients enrolled in a Phase I/IIb clinical trial of vaporized cannabis flower for cancer-related anorexia, along with 6 of their family carers. All patients perceived benefits to eating, though the mechanism varied.

Feasibility and Tolerability of Nabilone for the Treatment of Obesity: A Randomized Controlled Pilot Trial.

Matheson, Justin · 2025

The trial was terminated early because all four high-dose participants (6 mg/day) withdrew due to adverse events.

The role of tetrahydrocannabivarin (THCV) in metabolic disorders: A promising cannabinoid for diabetes and weight management.

Mendoza, Scott · 2025

THCV acts as a CB1 receptor antagonist and partial CB2 agonist, which in preclinical studies translated to appetite suppression, improved insulin sensitivity, enhanced glucose uptake, and reduced fat accumulation.

A cannabinoid receptor 1 inverse agonist induces weight loss and reduces airway hyperresponsiveness in a mouse model of obese asthma.

Morris, Carolyn R · 2025

The CB1R inverse agonist INV-202 produced 11% weight loss in lean and 27% in obese mice.

The appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial.

Nielsen, Rikke Lundsgaard · 2025

No statistically significant difference in mean caloric intake was observed between cannabis-based medicine and placebo (10 kcal difference, CI -55 to 75 kcal, favoring CBM).

Efficacy of cannabis oil on appetite and quality of life in systemic sclerosis patients: a randomized placebo-controlled trial.

Pisprasert, Veeradej · 2025

In a randomized placebo-controlled trial of 27 systemic sclerosis patients with anorexia or malnutrition, cannabis oil (two drops sublingual twice daily) showed trends toward greater improvements in appetite, body weight, calorie intake, and quality of life compared to placebo.

Design Considerations for Medicinal Cannabis Clinical Trials in People Receiving Palliative Care.

Razmovski-Naumovski, Valentina · 2025

This paper is a practical roadmap for researchers, drawn from the investigators' experience running a Phase I/IIb trial of vaporized cannabis for cancer anorexia.

Prescription and Nonprescription Drug Use Among People With Eating Disorders.

Rodan, Sarah-Catherine · 2025

Among 6,612 respondents with eating disorders, cannabis and psychedelics received the highest ratings for improving ED symptoms specifically.

Coadministration antagonist dopamine receptor D4 with CB2 receptor agonist decreases binge-like intake of palatable food in mice.

Rodríguez-Serrano, Luis Miguel · 2025

In mice given 1-hour access to palatable food, a dopamine D4 receptor antagonist (L-745870) reduced binge-like intake.

Cannabinoids drive feeding through AgRP neurons.

Yavuz, Yavuz · 2025

CB1 receptor activation reduced inhibitory signals to AgRP hunger neurons, increasing their activity.

Effect of oral cannabis administration on the fat depots of obese and streptozotocin-induced diabetic rats.

Ramlugon, Sonaal · 2023

Cannabis at 1.25 mg/kg body weight (relative to THC content) reversed insulin resistance, while higher doses did not.

The Metabolic Efficacy of a Cannabidiolic Acid (CBDA) Derivative in Treating Diet- and Genetic-Induced Obesity.

Ben-Cnaan, Elad · 2022

EPM301 (40 mg/kg/day) produced weight loss, increased physical activity, and improved glycemic and lipid profiles in diet-induced obese mice.

Case Report: Superior Mesenteric Artery Syndrome in an Adolescent With Cannabinoid Hyperemesis.

Berken, Jonathan A · 2022

A 17-year-old with a history of heavy cannabis use and recurrent nausea/vomiting meeting criteria for cannabinoid hyperemesis syndrome presented with sudden severe bilious vomiting.

Peripherally Selective CB1 Receptor Antagonist Improves Symptoms of Metabolic Syndrome in Mice.

Khan, Nayaab · 2021

The peripheral CB1 antagonist RTI1092769 inhibited weight gain, improved glucose utilization, and significantly reduced liver triglycerides and steatosis in mice on a high-fat diet.

Microstructure analysis of the effects of the cannabinoid agents HU-210 and rimonabant in rats licking for sucrose.

D'Aquila, Paolo S · 2020

HU-210 reduced licking by decreasing burst number and intra-burst lick rate (a motor competence index).

High fat-fed GPR55 null mice display impaired glucose tolerance without concomitant changes in energy balance or insulin sensitivity but are less responsive to the effects of the cannabinoids rimonabant or Δ(9)-tetrahydrocannabivarin on weight gain.

Wargent, Edward T · 2020

GPR55 knockout mice had worse glucose tolerance than wildtype mice on both standard and high-fat diets, despite no differences in body weight, composition, food intake, or energy expenditure.

Hair cannabinoid concentrations in emergency patients with cannabis hyperemesis syndrome.

Albert, Khala · 2019

Hair cannabinoid concentrations were similar between cannabis hyperemesis patients (THC median 220 pg/mg), recreational user controls (150 pg/mg), and emergency department controls (270 pg/mg).

Heavy Cannabis Use Associated with Wernicke's Encephalopathy.

Chaudhari, Amit · 2019

The patient presented with seizures secondary to cannabis hyperemesis-induced vomiting and hyponatremia.

Δ9-THC and related cannabinoids suppress substance P- induced neurokinin NK1-receptor-mediated vomiting via activation of cannabinoid CB1 receptor.

Darmani, Nissar A · 2019

Delta-9-THC, WIN55,212-2, and CP55,940 all dose-dependently suppressed vomiting triggered by substance P and the selective NK1 receptor agonist GR73632 in least shrews.

Targeting Peripheral CB1 Receptors Reduces Ethanol Intake via a Gut-Brain Axis.

Godlewski, Grzegorz · 2019

The peripheral CB1R inverse agonist JD5037 reduced ethanol drinking in wild-type mice but not in mice lacking CB1R, ghrelin, or the ghrelin receptor.

Cannabis Hyperemesis Syndrome in Palliative Care: A Case Study and Narrative Review.

Howard, Ileana · 2019

In a palliative care patient with advanced ALS, cannabis hyperemesis presented atypically without the classic hot bath behavior (due to physical disability).

Effects of cannabinoid modulation on hypothalamic nesfatin-1 and insulin resistance.

Kaya, Oktay · 2019

WIN 55,212-2 reduced brain nesfatin-1 immunoreactivity in sleep-deprived mice, an effect prevented by either CB1 or CB2 antagonists.

Resolution of Cannabinoid Hyperemesis Syndrome with Benzodiazepines: A Case Series.

Kheifets, Mark · 2019

All four patients presented with cyclical nausea, vomiting, and abdominal pain in the context of chronic cannabis use.

Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review.

McConachie, Sean M · 2019

Five full-text articles and 6 conference abstracts were included.

The Cannabinoid CB1 Antagonist TM38837 With Limited Penetrance to the Brain Shows Reduced Fear-Promoting Effects in Mice.

Micale, Vincenzo · 2019

Oral TM38837 required 10x higher doses than rimonabant to produce comparable fear-promoting effects (100 mg/kg vs 10 mg/kg).

Orosensory Detection of Dietary Fatty Acids Is Altered in CB₁R-/- Mice.

Brissard, Léa · 2018

Researchers discovered that the CB1 cannabinoid receptor, the same receptor activated by THC, plays a previously unknown role in the tongue's ability to detect and prefer dietary fats. Mice genetically engineered to lack CB1 receptors showed significantly lower preference for solutions containing rapeseed oil or the fatty acid linoleic acid compared to normal mice.

Novel Peripherally Restricted Cannabinoid 1 Receptor Selective Antagonist TXX-522 with Prominent Weight-Loss Efficacy in Diet Induced Obese Mice.

Chen, Wei · 2017

TXX-522, designed based on rimonabant's core structure but engineered for minimal brain penetration, showed potent anti-obesity effects in high-fat diet mice.

Cannabinoid CB1 receptor inverse agonist MJ08 stimulates glucose production via hepatic sympathetic innervation in rats.

Chen, Wei · 2017

MJ08, a CB1 receptor antagonist/inverse agonist more potent than rimonabant, was found to stimulate hepatic glucose production (HGP) in a dose-dependent manner in perfused rat livers.

Triazole Ureas Act as Diacylglycerol Lipase Inhibitors and Prevent Fasting-Induced Refeeding.

Deng, Hui · 2017

Through systematic medicinal chemistry, researchers created DH376 (compound 38), an inhibitor of diacylglycerol lipase (DAGL) with picomolar (trillionths of a molar) potency.

Anorexigenic effects induced by RVD-hemopressin(α) administration.

Ferrante, Claudio · 2017

Daily injections of RVD-hemopressin(alpha) (10 nmol) for 14 days reduced food intake in rats.

Pharmacological inhibition of cannabinoid receptor 1 stimulates gastric release of nesfatin-1 via the mTOR pathway.

Folgueira, Cintia · 2017

When rats were treated with the CB1 inverse agonist rimonabant, food intake decreased and gastric secretion of Nucb2/nesfatin-1 (a satiety peptide) increased.

Metabolic side effects induced by olanzapine treatment are neutralized by CB1 receptor antagonist compounds co-administration in female rats.

Lazzari, P · 2017

Weight gain is a major side effect of the antipsychotic olanzapine, and this study tested whether blocking CB1 cannabinoid receptors could counteract the metabolic problems without reducing the drug's psychiatric benefits. Female rats treated with olanzapine for 15 days gained weight and developed alterations in blood markers related to energy balance and glucose metabolism.

Differential effects of cannabinoid CB1 inverse agonists and antagonists on impulsivity in male Sprague Dawley rats: identification of a possibly clinically relevant vulnerability involving the serotonin 5HT1A receptor.

McLaughlin, Peter J · 2017

CB1 receptor inverse agonists like rimonabant showed promise as appetite suppressants but were withdrawn because they produced suicidal behavior in a small subpopulation during clinical trials.

A patient with a curious case of cyclical vomiting.

Phillips, Hayden R · 2017

The case describes the clinical presentation of cannabinoid hyperemesis syndrome, a condition increasingly recognized in emergency departments as cannabis legalization expands.

Cannabinoid hyperemesis syndrome: A disorder of the HPA axis and sympathetic nervous system?

Richards, John R · 2017

This hypothesis paper proposes a neurobiological mechanism for cannabinoid hyperemesis syndrome (CHS) that explains both the vomiting and the characteristic relief from hot water bathing. The author argues that chronic or excessive cannabis use leads to abnormal stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS).

Running Out of Options: Rhabdomyolysis Associated with Cannabis Hyperemesis Syndrome.

Trappey, Bernard E · 2017

A 24-year-old daily marijuana user with a history of CHS discovered that running, like hot bathing, alleviated his nausea and vomiting symptoms.

Pharmacological comparison of traditional and non-traditional cannabinoid receptor 1 blockers in rodent models in vivo.

Varga, Balázs · 2017

Researchers conducted the first direct comparison of classical and next-generation CB1 receptor blockers for anti-obesity potential and psychiatric side effects. All five classical CB1 antagonists (rimonabant, taranabant, otenabant, ibipinabant, surinabant) effectively reduced body weight and food intake in obese rats in a body weight-dependent manner, with only slight effects on metabolic syndrome markers.

Haloperidol, a Novel Treatment for Cannabinoid Hyperemesis Syndrome.

Witsil, Joanne C · 2017

Four patients with CHS who failed standard emergency department therapy (including conventional antiemetics) showed significant improvement after treatment with haloperidol, an antipsychotic that primarily blocks dopamine D2 receptors. The authors propose a mechanistic explanation: CHS involves dysregulation of cannabinoid type 1 (CB1) receptors, and recent animal research has revealed complex interactions between dopamine and CB1 signaling.

Prolonged activation of human islet cannabinoid receptors in vitro induces adaptation but not dysfunction.

Vilches-Flores, Alonso · 2016

Researchers exposed human pancreatic islets (the cell clusters that produce insulin) to cannabinoid receptor agonists for up to 5 days and measured the effects on gene expression, hormone secretion, and cell survival. Prolonged activation of both CB1 and CB2 receptors altered the expression of genes encoding endocannabinoid system components, showing the cells adapted to chronic stimulation.

The inhibitory effect of combination treatment with leptin and cannabinoid CB1 receptor agonist on food intake and body weight gain is mediated by serotonin 1B and 2C receptors.

Wierucka-Rybak, M · 2016

Previous research showed that combining leptin (a satiety hormone) with AM 251 (a CB1 receptor blocker) reduced food intake and body weight more effectively than either compound alone.

Tetrahydropyrazolo[4,3-c]pyridine derivatives as potent and peripherally selective cannabinoid-1 (CB1) receptor inverse agonists.

Zhu, Bin · 2016

The research team developed a new class of compounds (tetrahydropyrazolo[4,3-c]pyridine derivatives) that potently block CB1 cannabinoid receptors but are restricted to the body's periphery.

A cannabinoid receptor agonist N-arachidonoyl dopamine inhibits adipocyte differentiation in human mesenchymal stem cells.

Ahn, Seyeon · 2015

Three endocannabinoids were tested for their effects on fat cell (adipocyte) development from human bone marrow stem cells.

Cannabinoid hyperemesis syndrome: a guide for the practising clinician.

Bajgoric, Sanjin · 2015

The authors presented a case of a young man who developed cannabinoid hyperemesis syndrome (CHS), characterized by cyclic episodes of severe nausea, vomiting, and abdominal pain.

Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review.

Beech, Robert A · 2015

A 42-year-old woman was admitted to the hospital with a jaw fracture.

Prevention of Diet-Induced Obesity Effects on Body Weight and Gut Microbiota in Mice Treated Chronically with Δ9-Tetrahydrocannabinol.

Cluny, Nina L · 2015

Researchers gave daily THC to both diet-induced obese (DIO) and lean mice for 4 weeks.

Cannabinoid Hyperemesis Syndrome in a 17-Year-Old Adolescent.

Desjardins, Noémie · 2015

A 17-year-old visited the emergency department five times over one year with uncontrolled nausea, profuse vomiting, and weight loss.

13-year-old girl with recurrent, episodic, persistent vomiting: out of the pot and into the fire.

Felton, Diana · 2015

A 13-year-old with recurrent episodic vomiting was being screened for cannabis use because clinicians increasingly consider cannabinoid hyperemesis syndrome (CHS) in patients with cyclic vomiting.

Cannabinoid Hyperemesis Syndrome: A Paradoxical Cannabis Effect.

Figueroa-Rivera, Ivonne Marie · 2015

A 29-year-old man presented with recurrent episodes of intractable vomiting that followed the classical triad of cannabinoid hyperemesis syndrome: cyclic vomiting, chronic marijuana use, and compulsive hot bathing.

Cannabinoid hyperemesis syndrome.

Heise, Lynn · 2015

This review for emergency nursing practitioners outlined the key features of CHS.

ENP11, a potential CB1R antagonist, induces anorexia in rats.

Méndez-Díaz, Mónica · 2015

Researchers synthesized ENP11, a chemical analog of rimonabant (the CB1 receptor blocker that was withdrawn from the market due to psychiatric side effects), and tested it in rats at three doses. ENP11 reduced food intake during the first hour after administration.

The CB1 Neutral Antagonist Tetrahydrocannabivarin Reduces Default Mode Network and Increases Executive Control Network Resting State Functional Connectivity in Healthy Volunteers.

Rzepa, Ewelina · 2015

Researchers gave 20 healthy volunteers a single 10mg oral dose of THCV or placebo in a randomized crossover design, then scanned their brains with resting-state fMRI. THCV produced no subjective effects (no feeling of being high), as expected for a CB1 neutral antagonist.

Case of cannabinoid hyperemesis syndrome with long-term follow-up.

Cha, Jae Myung · 2014

A 44-year-old man with a long history of marijuana addiction had suffered from chronic abdominal pain and attacks of uncontrollable vomiting for 16 years.

Cannabis withdrawal syndrome: An important diagnostic consideration in adolescents presenting with disordered eating.

Chesney, Tyler · 2014

Three adolescents presented to an eating disorders program with gastrointestinal symptoms, food avoidance, and weight loss.

Cannabinoid hyperemesis syndrome: a case report and review of pathophysiology.

Iacopetti, Corina L · 2014

A patient with a long history of nausea and vomiting had previously undergone extensive diagnostic workup and received a diagnosis of cyclic vomiting syndrome.

Nabilone therapy for cannabis withdrawal presenting as protracted nausea and vomiting.

Lam, Philip W · 2014

A 20-year-old woman developed protracted nausea and vomiting after abruptly stopping chronic cannabis use.

Attenuation of anticipatory nausea in a rat model of contextually elicited conditioned gaping by enhancement of the endocannabinoid system.

Limebeer, Cheryl L · 2014

Rats that received JZL195, a dual inhibitor of the enzymes FAAH and MAGL, showed significantly less anticipatory nausea behavior (contextually elicited gaping) compared to untreated animals.

Marijuana use and maternal experiences of severe nausea during pregnancy in Hawai'i.

Roberson, Emily K · 2014

Among 4,735 recently pregnant women in Hawaii, 6.0% reported marijuana use in the month before pregnancy and 2.6% reported use during pregnancy.

An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).

Venkatesan, Thangam · 2014

Of 437 CVS patients who completed questions about marijuana use, 81% reported use and only 19% had never used.

Cannabinoid hyperemesis syndrome.

Sun, Shusen · 2013

This review described cannabinoid hyperemesis syndrome (CHS), a condition associated with long-term cannabis use characterized by cycles of severe nausea and vomiting without another identifiable cause.

Cannabinoid hyperemesis syndrome: a case series and review of previous reports.

Nicolson, Stephen E · 2012

The authors described four patients who experienced recurring cycles of intense nausea and vomiting that were linked to long-term, heavy cannabis use.

Cannabis use amongst patients with inflammatory bowel disease.

Lal, Simon · 2011

Researchers surveyed 100 ulcerative colitis (UC) and 191 Crohn's disease (CD) patients at a specialty clinic about cannabis use. Lifetime cannabis use was similar between groups: 51% of UC and 48% of CD patients.

Cannabinoid hyperemesis syndrome: an underreported entity causing nausea and vomiting of pregnancy.

Schmid, Seraina M · 2011

This case report described a 26-year-old patient admitted at 10 weeks of pregnancy with severe nausea and vomiting unresponsive to standard antiemetic drugs.

Pediatric cannabinoid hyperemesis: two cases.

Miller, Joseph B · 2010

Two adolescent patients presented with severe nausea and uncontrollable vomiting (hyperemesis) in the setting of chronic marijuana use.

The cannabis hyperemesis syndrome characterized by persistent nausea and vomiting, abdominal pain, and compulsive bathing associated with chronic marijuana use: a report of eight cases in the United States.

Soriano-Co, Maria · 2010

Eight patients with cannabinoid hyperemesis syndrome (CHS) were identified at a single US hospital between January and August 2009.

Cannabinoid hyperemesis.

Wild, Kim · 2010

A 21-year-old woman presented with four weeks of sudden-onset vomiting, nausea, and appetite loss.

Biological effects of THC and a lipophilic cannabis extract on normal and insulin resistant 3T3-L1 adipocytes.

Gallant, M · 2009

Researchers tested a lipophilic (fat-soluble) cannabis extract on mouse fat cells (3T3-L1 adipocytes) in several experiments. When applied during fat cell development, increasing THC concentrations reduced the rate of adipogenesis (fat cell formation) while simultaneously increasing insulin-stimulated glucose uptake. When cells were made insulin-resistant using TNF-alpha (a molecule linked to inflammation and insulin resistance), the cannabis extract restored insulin-stimulated glucose uptake in these resistant cells. Gene expression analysis showed effects on glucose transporter (GLUT-4) and insulin receptor substrate (IRS-1 and IRS-2) genes..

The metabolic implications of long term cannabis use in patients with psychosis.

Mushtaq, Farrah · 2008

This narrative review examined how cannabis use might affect metabolic health in people with psychosis, a population already at elevated risk for cardiovascular and metabolic disease. In the general population, cannabis's short-term appetite-stimulating effects through the endocannabinoid system are well documented.

Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?

Russo, Ethan B · 2004

The review proposed a novel medical theory: clinical endocannabinoid deficiency (CECD).

The time course and significance of cannabis withdrawal

Budney, Alan J. · 2003

After heavy users stopped, a consistent withdrawal pattern emerged across mood, sleep, and physical symptoms.