rethinkTHC Search
Menu
Study breakdown

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

Systematic ReviewModerate evidence
The takeaway

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?
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 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

Explore the wider topic