To evaluate the safety and effectiveness of the topical application of capsaicin cream as a treatment for vomiting due to suspected cannabinoid hyperemesis syndrome (CHS) in the emergency department (ED)Īdults ≥18 years presenting with suspected exacerbation of CHS and had active vomiting or nausea in the ED Randomized, double-blind, placebo-controlled pilot trial doi:10.1080/15563650.2019.1660783Ī Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department. Wagner S, Hoppe J, Zuckerman M, Schwarz K, McLaughlin J. Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. McConachie SM, Caputo RA, Wilhelm SM, Kale-Pradhan PB. Some reports described multiple capsaicin doses administered every four hours. A retrospective cohort study utilized capsaicin doses of 0.025% 0.075%, and 0.1%, but the 0.075% dose was the most frequently utilized (25/43 patients). The case series and case reports described a total of 12 patients who significantly improved following administration of capsaicin 0.075% cream however, some reports studied capsaicin doses of 0.025% and 1.5%. Capsaicin use was described as beneficial in all case series and case reports however, both retrospective cohort studies were unable to find a significant benefit for capsaicin on primary outcomes (emergency department length of stay). Ī systematic review selected 11 case reports and retrospective cohort studies in which capsaicin was used to reduce CHS-related symptoms. TRPV1 is a nociceptive receptor that is activated by extremely hot temperatures. These phases are still poorly understood but it is theorized that topical capsaicin, a transient receptor potential vanilloid 1 (TRPV1) receptor agonist, may be used as a first-line agent to effectively reduce symptoms. The recovery phase is the cessation of cannabis and the decline of related symptoms. The prodromal phase tends to be characterized by abdominal discomfort, fear of vomiting, and early morning nausea while the hyperemetic phase tends to be associated with frequent nausea, overwhelming episodes of vomiting, and a compulsive need to bathe in hot water for symptom relief. This condition is divided into 3 symptom-dependent phases, which include the prodromal, hyperemetic, and recovery phases. Cannabinoid Hyperemesis Syndrome (CHS) is characterized by cyclic episodes of nausea, vomiting, and abdominal pain, which are alleviated in most cases by hot showers, as reported by chronic cannabis users.
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