Cannabis is the most commonly used illicit drug in the world and use has increased each year in the United States. Since legalization in many states, cannabis is becoming even more widely used. As use has increased, so has a variant of cyclic vomiting syndrome, called cannabinoid hyperemesis syndrome. Patients experiencing cannabinoid hyperemesis syndrome frequent the emergency department for IV antiemetics and rehydration, but these symptomatic treatments are often ineffective resulting in use of many different pharmacologic treatments. The objective of this study was to compare current pharmacologic treatment for cannabinoid hyperemesis syndrome. The systematic review included 63 studies with a total of 205 patients. The participating studies included prospective longitudinal cohorts, retrospective cohorts, case series, and case reports. The review found that there was a lack of high-quality studies focusing on acute pharmacologic treatment of CHS. Most studies reported that benzodiazepine, haloperidol, and capsaicin were found to be effective in acute treatment of CHS. Given the rising prevalence of cannabis use, future prospective studies are necessary to elucidate an effective and standardized therapy for acute cannabinoid hyperemesis syndrome.
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