Adolescent cannabinoid hyperemesis syndrome presents similarly to adults but may be more common in females

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.

Zhu, Jie Wei et al.·The Journal of adolescent health : official publication of the Society for Adolescent Medicine·2021·Moderate EvidenceSystematic Review
RTHC-03642Systematic ReviewModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Systematic Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

Databases searched: 5. Initial records: 1,334. Full-text reviewed: 148. Included: 21 studies. Earliest adolescent case: age 15. Anxiety/depression comorbidity: 21%.

How They Did This

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).

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
21% of adolescent CHS patients had comorbid anxiety or depression
Evidence Grade:
Systematic review with comprehensive search, but limited by the low quality of available primary studies.
Study Age:
Published in 2021 covering literature through December 2019.
Original Title:
Diagnosis and Acute Management of Adolescent Cannabinoid Hyperemesis Syndrome: A Systematic Review.
Published In:
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 246-254 (2021)
Database ID:
RTHC-03642

Evidence Hierarchy

Meta-Analysis / Systematic ReviewCombines many studies into one answer
This study
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Analyzes all available research on a topic using a structured method.

What do these levels mean? →

Frequently Asked Questions

Is CHS different in adolescents compared to adults?

It follows the same diagnostic criteria but may present more frequently in females. The earliest reported adolescent case was at age 15, and 21% had comorbid anxiety or depression.

What treats CHS in adolescents?

Complete cannabis cessation is the only effective treatment. Haloperidol and capsaicin cream may provide temporary symptom relief in some cases.

Read More on RethinkTHC

Cite This Study

RTHC-03642·https://rethinkthc.com/research/RTHC-03642

APA

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

MLA

Zhu, Jie Wei, et al. "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, 2021. https://doi.org/10.1016/j.jadohealth.2020.07.035

RethinkTHC

RethinkTHC Research Database. "Diagnosis and Acute Management of Adolescent Cannabinoid Hyp..." RTHC-03642. Retrieved from https://rethinkthc.com/research/zhu-2021-diagnosis-and-acute-management

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.