A systematic review of 21 studies found adolescent CHS follows adult diagnostic criteria but may present more frequently in females, with 21% having comorbid anxiety or depression and complete cannabis cessation being the only effective treatment.
Pediatric emergency physicians, adolescent medicine specialists, and gastroenterologists.
21% of adolescent CHS patients had comorbid anxiety or depression
What the researchers found
Adolescent CHS fulfills adult diagnostic criteria. It may present more frequently in females, with the earliest case at age 15. A substantial proportion (21%) had anxiety and depression history. While haloperidol and capsaicin may offer temporary relief, complete cannabis cessation is the only known effective treatment.
Why it matters
With adolescent cannabis use increasing, recognizing CHS in younger patients is critical for avoiding unnecessary diagnostic workups and directing treatment toward the root cause.
The numbers in context
Databases searched: 5. Initial records: 1,334. Full-text reviewed: 148. Included: 21 studies. Earliest adolescent case: age 15. Anxiety/depression comorbidity: 21%.
How the study worked
Systematic review searching five databases for studies published December 1954 to December 2019. From 1,334 initial records, 148 underwent full-text review, yielding 21 included studies (10 on diagnosis, 11 on treatment).
What this study cannot tell us
Limited number of adolescent-specific studies (21). Most evidence from case reports and small series. Publication bias likely. Cannot determine true CHS prevalence in adolescents.
How to read the evidence
Systematic review with comprehensive search, but limited by the low quality of available primary studies.
When this study was published
Published in 2021 covering literature through December 2019.
The bigger picture
The 21% anxiety/depression comorbidity raises questions about whether these conditions drive cannabis use that leads to CHS, or whether the distress of recurrent vomiting episodes contributes to mood disorders.
Questions still open
- Why might adolescent CHS present more often in females? Is the 21% anxiety/depression rate higher than expected for this age group? What interventions best support cannabis cessation in adolescents with CHS?
Common questions
Is CHS different in adolescents compared to adults?
What treats CHS in adolescents?
Read the original research
Diagnosis and Acute Management of Adolescent Cannabinoid Hyperemesis Syndrome: A Systematic Review.
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 246-254
Citation
Zhu, Jie Wei; Gonsalves, Clarelle L; Issenman, Robert M; Kam, April J. (2021). Diagnosis and Acute Management of Adolescent Cannabinoid Hyperemesis Syndrome: A Systematic Review.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 246-254. https://doi.org/10.1016/j.jadohealth.2020.07.035
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