Topical capsaicin cream in the treatment for cannabinoid hyperemesis syndrome

Román, Francisco; Llorens, Pere; Burillo-Putzé, Guillermo

doi:10.1016/j.medcle.2016.12.026

Cited by 11 publications

(16 citation statements)

References 1 publication

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“…However, data suggest that metoclopramide is not an effective treatment for cyclic vomiting syndrome . A total of 13 metoclopramide treatment failures were noted for CHS based on our review . The butyrophenone haloperidol was reported as effective in several case series and reports that may reflect its unique pharmacology relative to the other more common antiemetics .…”

Section: Discussionmentioning

confidence: 89%

“…For these case series, the following CHS pharmacologic treatments were reported as helpful: benzodiazepines (six), topical capsaicin (five), haloperidol (five), and olanzapine (one) . The 44 level‐5 case reports involved 44 patients . For these case reports, the following CHS pharmacologic treatments were reported as effective: benzodiazepines (five), metoclopramide (four), haloperidol (four), ondansetron (two), morphine (two), and topical capsaicin (two) .…”

Section: Resultsmentioning

confidence: 99%

“…10,11, For these case reports, the following CHS pharmacologic treatments were reported as effective: benzodiazepines (five), metoclopramide (four), haloperidol (four), ondansetron (two), morphine (two), and topical capsaicin (two). 11,34,37,38,45,46,48,50,51,53,58,60,64,69,72,73 Other effective treatments mentioned only once included fentanyl, promethazine, methadone, nabilone, levomepromazine, piritramide, and pantoprazole. 37,38,43,56,66 Of note, hot showers and bathing were mentioned either by the authors or patients in all level-4 and -5 articles as universally effective at ameliorating CHS.…”

Section: Resultsmentioning

confidence: 99%

“…As such, TRPV1 receptors may play a teleological role in the efficacy of hot showers/baths for symptomatic relief of CHS. Seven patients with acute CHS successfully treated with topical capsaicin were reported …”

Section: Discussionmentioning

confidence: 99%

“…78 Serotonin, or 5-hydroxytryptamine (5-HT), is a major neuroendocrine transmitter in the regulation of emesis. 77 Histamine activates neurons 70 Diazepam, haloperidol, ondansetron 5 1 Authors did not report success of specific treatments Case report 71 Promethazine, ondansetron, tramadol, chlordiazepoxide/clidinium, amitriptyline 5 1 Authors did not report success of specific treatments Case report 72 Capsaicin, metoclopramide, granisetron 5 1 Metoclopramide and granisetron ineffective, successful treatment with 0.075% capsaicin cream Case report 73 Ondansetron, lorazepam, haloperidol 5 1 Ondansetron and lorazepam ineffective; successful treatment with haloperidol Case report 74 Lorazepam, ondansetron 5 1…”

Section: Medications Ineffectivementioning

confidence: 99%

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Pharmacologic Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review

et al. 2017

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Cannabinoid hyperemesis syndrome (CHS) has become more prevalent with increasing cannabis use. CHS is often resistant to standard antiemetics. The objective of this study is to review the current evidence for pharmacologic treatment of CHS. Medline, PsycINFO, DARE, OpenGrey, Google Scholar, and the Cochrane Library were searched from inception to February 2017. Articles were selected and reviewed independently. Evidence was graded using Oxford Center for Evidence-Based Medicine guidelines. The search resulted in 1262 articles with 63 of them eligible for inclusion (205 human subjects). There were 4 prospective level-2, 3 retrospective level-3 studies, 12 level-4 case series, and 44 level-5 case reports. Among level-2 studies (64 subjects), tricyclic antidepressants (TCAs) and lorazepam were discussed as effective long- and short-term treatments, respectively, in two studies. Ondansetron, promethazine, diphenhydramine, and opioids were also mentioned, but the authors did not comment on their efficacy. Among level-3 studies (43 subjects), one reported effective treatment with antiepileptics zonisamide and levetiracetam, but not TCAs. Another reported favorable response to morphine, ondansetron, and lorazepam but did not specify the actual number of patients receiving specific treatment. Among the level-4 case series (54 subjects), benzodiazepines, haloperidol, and capsaicin were reported as helpful. For level-5 case reports (44 subjects), benzodiazepines, metoclopramide, haloperidol, ondansetron, morphine, and capsaicin were reported as effective. Effective treatments mentioned only once included fentanyl, diazepam, promethazine, methadone, nabilone, levomepromazine, piritramide, and pantoprazole. Hot showers and baths were cited in all level-4 and -5 articles as universally effective. High-quality evidence for pharmacologic treatment of CHS is limited. Benzodiazepines, followed by haloperidol and capsaicin, were most frequently reported as effective for acute treatment, and TCAs for long-term treatment. As the prevalence of CHS increases, future prospective trials are greatly needed to evaluate and further define optimal pharmacologic treatment of patients with CHS.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%