Cannabinoid hyperemesis syndrome: a review of the literature

Cannabinoid Hyperemesis Syndrome (CHS) is characterized by cyclic vomiting and compulsive need to take hot showers in the context of chronic cannabis use. Physicians' lack of knowledge of CHS often results in a diagnostic delay of several years. The purpose of this article is to describe CHS in order to enable physicians, and more particularly psychiatrists, to diagnose it as quickly as possible and thus avoid unnecessary additional invasive examinations.

Bibliographic search for scientific articles published between 2004 and 2019 in the Cochrane, Medline, PubMed, and Psycinfo databases. Key words used were "hyperemesis", "cannabis", "cannabinoid".

CHS is associated with chronic cannabis use and typically manifests as incoercible cyclical vomiting, diffuse abdominal pain, and relief of symptoms by taking hot showers. Patients suffering from CHS generally visit emergency departments very regularly and undergo numerous additional examinations, both invasive and unnecessary. Since no organic cause can explain these symptoms, these patients are referred to the psychiatry department. The only curative treatment is the complete cessation of cannabis use.

CHS is an under-diagnosed pathology because it is little known to physicians. This syndrome has unique clinical characteristics. Early recognition of CHS avoids repeated visits to the emergency room and unnecessary follow-up examinations.