TY - JOUR
T1 - Resolution of cannabinoid hyperemesis syndrome with benzodiazepines
T2 - A case series
AU - Kheifets, Mark
AU - Karniel, Eli
AU - Landa, Daniel
AU - Vons, Shelly Abigail
AU - Meridor, Katya
AU - Charach, Gideon
N1 - Publisher Copyright:
© 2019, Israel Medical Association. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - Background: Cannabinoid hyperemesis syndrome (CHS) is under-recognized by clinicians. It is characterized by nausea, severe abdominal pain, and cyclical vomiting In the context of chronic cannabis use. Oral benzodiazepine is a proposed treatment for CHS. It decreases activation of Cannabinoid Type 1 Receptor (CB1) In the frontal cortex, has a sedative and hypnotic effect and reduces the anticipation of nausea and vomiting. These effects on the central nervous system (CNS) might explain Its beneficial antiemetic effect for this syndrome. Objectives: To Increase the Index of suspicion for CHS, a unique syndrome that requires a unique treatment with benzodiazepines and not antiemetics. Methods: We describe a series of four patients with documented cannabis use, who were admitted to an Internal medicine department of Meir Medical Center due to symptoms consistent with abdominal pain, nausea, and vomiting. They were initially treated with conventional antiemetics and proton pump Inhibitors without response. Intensive Investigations were conducted to exclude common and sometimes urgent gastrointestinal or CNS syndromes. Results: After excluding urgent gastrointestinal and CNS origins for the vomiting, we suspected CHS. All four patients experienced similar symptoms and failure of conventional treatment with antiemetics and proton pump Inhibitors. They experienced relief after administration of benzodiazepines. Conclusions: A high index of suspicion for CHS allows for rapid, appropriate treatment with benzodiazepines, which In turn may lead to cessation of the debilitating symptoms caused by this syndrome.
AB - Background: Cannabinoid hyperemesis syndrome (CHS) is under-recognized by clinicians. It is characterized by nausea, severe abdominal pain, and cyclical vomiting In the context of chronic cannabis use. Oral benzodiazepine is a proposed treatment for CHS. It decreases activation of Cannabinoid Type 1 Receptor (CB1) In the frontal cortex, has a sedative and hypnotic effect and reduces the anticipation of nausea and vomiting. These effects on the central nervous system (CNS) might explain Its beneficial antiemetic effect for this syndrome. Objectives: To Increase the Index of suspicion for CHS, a unique syndrome that requires a unique treatment with benzodiazepines and not antiemetics. Methods: We describe a series of four patients with documented cannabis use, who were admitted to an Internal medicine department of Meir Medical Center due to symptoms consistent with abdominal pain, nausea, and vomiting. They were initially treated with conventional antiemetics and proton pump Inhibitors without response. Intensive Investigations were conducted to exclude common and sometimes urgent gastrointestinal or CNS syndromes. Results: After excluding urgent gastrointestinal and CNS origins for the vomiting, we suspected CHS. All four patients experienced similar symptoms and failure of conventional treatment with antiemetics and proton pump Inhibitors. They experienced relief after administration of benzodiazepines. Conclusions: A high index of suspicion for CHS allows for rapid, appropriate treatment with benzodiazepines, which In turn may lead to cessation of the debilitating symptoms caused by this syndrome.
KW - Abdominal pain, benzodiazepines
KW - Cannabis
KW - Cannabis hyperemesis syndrome (CHS)
KW - Hydrotherapy
UR - http://www.scopus.com/inward/record.url?scp=85069292491&partnerID=8YFLogxK
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C2 - 31280510
AN - SCOPUS:85069292491
SN - 1565-1088
VL - 21
SP - 404
EP - 407
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 6
ER -