Cannabinoid Hyperemesis Syndrome: Case Report of a Paradoxical Reaction with Heavy Marijuana UseReportar como inadecuado

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Case Reports in MedicineVolume 2012 2012, Article ID 757696, 3 pages

Case ReportDepartment of Internal Medicine, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA

Received 24 January 2012; Revised 22 March 2012; Accepted 2 April 2012

Academic Editor: Mohammad Abdollahi

Copyright © 2012 Benjamin Cox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cannabinoid hyperemesis syndrome CHS is a rare constellation of clinical findings that includes a history of chronic heavy marijuana use, severe abdominal pain, unrelenting nausea, and intractable vomiting. A striking component of this history includes the use of hot showers or long baths that help to alleviate these symptoms. This is an underrecognized syndrome that can lead to expensive and unrevealing workups and can leave patients self-medicating their nausea and vomiting with the very substance that is causing their symptoms. Long-term treatment of CHS is abstinence from marijuana use—but the acute symptomatic treatment of CHS has been a struggle for many clinicians. Many standard medications used for the symptomatic treatment of CHS including ondansetron, promethazine, and morphine have repeatedly been shown to be ineffective. Here we present the use of lorazepam as an agent that successfully and safely treats the tenacious symptoms of CHS. Additionally, we build upon existing hypotheses for the pathogenesis of CHS to try to explain why a substance that has been used for thousands of years is only now beginning to cause this paradoxical hyperemesis syndrome.

Autor: Benjamin Cox, Akansha Chhabra, Michael Adler, Justin Simmons, and Diana Randlett



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