Capsaicin for Symptomatic Relief of Cannabinoid Hyperemesis Syndrome

Authors

  • Amber Minett 4th year BPharm(Hons)- University of Newcastle, NSW, Australia
  • Melanie Harrison Senior Pharmacist, Emergency Medicine/Critical Care, Calvary Mater Newcastle Hospital, NSW, Australia

Keywords:

pharmacy research, Cannabinoid Hyperemesis Syndrome , cannabis , student-led journal , capsaicin

Abstract

Cannabinoid Hyperemesis Syndrome (CHS) is a condition that affects particular people who use cannabis chronically, where they experience intractable nausea and vomiting that is refractive to standard antiemetic treatment. The transient receptor potential, vanilloid 1 (TRPV1) receptor, is currently being studied as a potential target for the treatment of CHS using topical capsaicin. This study aimed to assess the efficacy of topical capsaicin cream in the treatment of symptoms of nausea and vomiting associated with CHS. A retrospective cohort study was conducted on 37 patients that presented to the Calvary Mater Newcastle Hospital from December 2019 to October 2021 displaying cyclical nausea and vomiting, that was associated with chronic cannabis use. Data was collected from patients’ paper and electronic-based records, if they met the inclusion criteria, and were treated with 0.025% topical capsaicin cream. 30 patients displayed improved symptom relief after the application of the cream, and seven patients experienced no effect from the cream. This study provided an insight into the effects of capsaicin in an Australian population, and can provide medical staff within hospital emergency departments with a potential treatment modality for patients presenting with CHS.

References

McConachie SM, Caputo RA, Wilhelm SM, Kale-Pradhan PB. Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. Ann Pharmacother [Internet]. 2019 [cited 2022 Jan 10];53(11):1145-52. Available from: https://pubmed.ncbi.nlm.nih.gov/31104487/ doi:10.1177/1060028019852601

DeVuono MV, Parker LA. Cannabinoid Hyperemesis Syndrome: A Review of Potential Mechanisms. Cannabis Cannabinoid Res [Internet]. 2020 [cited 2022 Jan 10];5(2):132-44. Available from: https://pubmed.ncbi.nlm.nih.gov/32656345/ doi:10.1089/can.2019.0059

Richards JR, Lapoint JM, Burillo-Putze G. Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment. Clin Toxicol (Phila) [Internet]. 2018 [cited 2022 Jan 10];56(1):15-24. Available from: https://pubmed.ncbi.nlm.nih.gov/28730896/ doi:10.1080/15563650.2017.1349910

Stumpf JL, Williams LD. Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin. J Pharm Pract [Internet]. 2020 [cited 2022 Jan 10]. Available from: https://pubmed.ncbi.nlm.nih.gov/32613883/ doi:10.1177/0897190020934289

Zhu JW, Gonsalves CL, Issenman RM, Kam AJ. Diagnosis and Acute Management of Adolescent Cannabinoid Hyperemesis Syndrome: A Systematic Review. J Adolesc Health [Internet]. 2021 [cited 2022 Jan 10];68(2):246-54. Available from: https://pubmed.ncbi.nlm.nih.gov/33036874/ doi:10.1016/j.jadohealth.2020.07.035

Frederick CC, M. Cannabinoid Hyperemesis Syndrome NCBI: StatPearls Publishing [Internet]. 2021 [updated 2021 Jul 17; cited 2022 Jan 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549915/

Richards JR. Cannabinoid Hyperemesis Syndrome: Pathophysiology and Treatment in the Emergency Department. J Emerg Med [Internet]. 2018 [cited 2022 Jan 10];54(3):354-63. Available from: https://pubmed.ncbi.nlm.nih.gov/29310960/ doi:10.1016/j.jemermed.2017.12.010

Rudd JA, Nalivaiko E, Matsuki N, Wan C, Andrews PL. The involvement of TRPV1 in emesis and anti-emesis. Temperature (Austin) [Internet]. 2015 [cited 2022 Jan 10];2(2):258-76. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843889/ doi:10.1080/23328940.2015.1043042

Zhang M, Ruwe D, Saffari R, Kravchenko M, Zhang W. Effects of TRPV1 Activation by Capsaicin and Endogenous N-Arachidonoyl Taurine on Synaptic Transmission in the Prefrontal Cortex. Front Neurosci [Internet]. 2020 [cited 2022 Jan 10];14:91. Available from: https://www.frontiersin.org/articles/10.3389/fnins.2020.00091/full doi:10.3389/fnins.2020.00091

Moon AM, Buckley SA, Mark NM. Successful Treatment of Cannabinoid Hyperemesis Syndrome with Topical Capsaicin. ACG Case Rep J [Internet]. 2018 [cited 2022 Jan 10];5:e3. Available from: https://pubmed.ncbi.nlm.nih.gov/29379817/ doi:10.14309/crj.2018.3

Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut [Internet]. 2004 [cited 2022 Jan 10];53(11):1566-70. Available from: https://gut.bmj.com/content/53/11/1566 doi:10.1136/gut.2003.036350

Dean DJ, Sabagha N, Rose K, Weiss A, France J, Asmar T, et al. A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome. Acad Emerg Med [Internet]. 2020 [cited 2022 Jan 10];27(11):1166-72. Available from: https://pubmed.ncbi.nlm.nih.gov/32569429/ doi:10.1111/acem.14062

Lee C, Greene SL, Wong A. The utility of droperidol in the treatment of cannabinoid hyperemesis syndrome. Clinical Toxicology [Internet]. 2019 [cited 2022 Jan 10];57(9):773-7. Available from: https://pubmed.ncbi.nlm.nih.gov/30729854/ doi:10.1080/15563650.2018.1564324

Australasian College of Emergency Medicine. Guidelines on the Implementation of the ATS in EDs [PDF file from the internet]. Melbourne, Victoria: Australasian College of Emergency Medicine; 2016 [cited 2022 Jan 10]. Available from: https://acem.org.au/getmedia/51dc74f7-9ff0-42ce-872a-0437f3db640a/G24_04_Guidelines_on_Implementation_of_ATS_Jul-16.aspx

Wagner S, Hoppe J, Zuckerman M, Schwarz K, McLaughlin J. Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department. Clin Toxicol (Phila) [Internet]. 2020 [cited 2022 Jan 10];58(6):471-5. Available from: https://pubmed.ncbi.nlm.nih.gov/31482758/ doi:10.1080/15563650.2019.1660783

Downloads

Published

25.01.2022

Issue

Section

Articles