Use of Capsaicin Cream in Cannabinoid Hyperemesis Syndrome in Patients Presenting to the Emergency Department.

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  • Author(s): Lee A;Lee A; Coralic Z; Coralic Z; Coralic Z
  • Source:
    The Annals of pharmacotherapy [Ann Pharmacother] 2022 Feb; Vol. 56 (2), pp. 151-154. Date of Electronic Publication: 2021 May 17.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Sage Country of Publication: United States NLM ID: 9203131 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-6270 (Electronic) Linking ISSN: 10600280 NLM ISO Abbreviation: Ann Pharmacother Subsets: MEDLINE
    • Publication Information:
      Publication: Sept. 2013- : Thousand Oaks, CA : Sage
      Original Publication: Cincinnati, OH : Harvey Whitney Books Co., c1992-
    • Subject Terms:
      Cannabinoids*/adverse effects ; Capsaicin*/adverse effects; Emergency Service, Hospital ; Humans ; Retrospective Studies ; Vomiting/chemically induced ; Vomiting/drug therapy
    • Abstract:
      Background: Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclical nausea, vomiting, and abdominal pain often relieved with hot showers. Patients with CHS are usually long-term cannabis smokers whose symptoms are not relieved by antiemetics. The use of topical capsaicin has been recently reported as an adjunctive therapy in the emergency department (ED).
      Objective: To describe the use of capsaicin cream in patients presenting to the ED with suspected CHS.
      Methods: We performed a retrospective review of patients with suspected CHS receiving capsaicin in an ED from July 2014 to October 2018. We report data on demographics, cannabis consumption, hot showers use, length of stay, concurrent treatments, pain scores, and adverse events.
      Results: There were 57 patients who received capsaicin cream for suspected CHS. Nearly all patients received antiemetics (98%), whereas 47% of patients received an opioid. Antiemetics were typically administered first (median, 1.6 hours; interquartile range [IQR], 0.9-2.4]), followed by an opioid (median, 1.8 hours [IQR, 1-3.75]), followed by capsaicin cream (median 4 hours [IQR, 2.7-5.2]). The overall precapsaicin pain score was 8 (IQR, 2-9), decreasing to 5.5 (IQR, 0-8). Around 42% of patients received no further symptomatic therapy after capsaicin. No adverse drug events to capsaicin were reported.
      Conclusion and Relevance: This is the largest retrospective study describing capsaicin cream use in suspected CHS patients with a focus on abdominal pain relief. Capsaicin treatment was associated with a modest pain score reduction. Application of these findings may help providers in identifying more effective therapies to provide symptomatic relief for CHS patients.
    • Contributed Indexing:
      Keywords: cannabinoid hyperemesis syndrome; clinical pharmacy; emergency medicine; gastroenterology; nausea/vomiting; pain management; substance abuse
    • Accession Number:
      0 (Cannabinoids)
      S07O44R1ZM (Capsaicin)
    • Publication Date:
      Date Created: 20210517 Date Completed: 20220107 Latest Revision: 20220107
    • Publication Date:
      20221213
    • Accession Number:
      10.1177/10600280211018516
    • Accession Number:
      33998315