Cannabinoid Hyperemesis Syndrome CHS: Causes, Symptoms & Treatment

Ten studies were rated as having a low risk of bias [2,3,4, 17,18,19,20,21,22,23], one was rated as having an unclear risk of bias [24], and two studies were rated as having a high risk, due to selective outcome reporting [25, 26]. Results of the risk of bias assessment are described in Table S3. While CBD can be tolerated in fairly high doses and isn’t intoxicating, it can have negative side effects. Because of its anxiolytic, anti-inflammatory, antinausea and antipsychotic effects, CBD is used to treat many physical and psychological symptoms in both humans and animals.

The effects of subacute exposure to a water-soluble cannabinol compound in male mice

  • The majority of cases with abnormal liver function tests were in children with epilepsy who were also being treated with sodium valproate.
  • If a study reported both treatment-related adverse events and adverse events we preferentially extracted adverse events, to reduce the risk of unanticipated adverse events being inadvertently disregarded.
  • Anxiety and/or panic are the most common reactions; they are of sudden onset during or shortly after smoking, or they can appear more gradually 1-2 hours after an oral dose.
  • The mean oral dose used was 1132 mg/day and the median dose was 1200 mg/day.
  • Without knowing this background, providers often misdiagnose CHS as other conditions, like cyclic vomiting syndrome (CVS).
  • After assessing him, his health team administered intravenous fluids, oxygen, anti-emetics for vomiting, and consistent stimulation.

The systematic search identified 28 independent randomized double-blind placebo-controlled clinical trials (Fig. 1), comprising data from a total of 1589 participants. Ten studies were excluded from further analysis because they were only reported in abstracts, posters or secondary descriptions from the grey literature. A further five were excluded because they did not report data on withdrawal or adverse events in a systematic way.

Health effects during pregnancy and breastfeeding

Most cannabis users begin use when younger than 20 years of age, with the peak incidence of onset between 16 and 18 years. This case report highlights the delay and variability in absorption rates and intoxication with ingesting THC products. Effects take 1-2 hours to peak with ingestion, vs 5-10 minutes with smoking. The elimination half-life of THC can range from 2-57 hours following intravenous use and inhalation. The half-life of 11-OH-THC, the active metabolite of THC, is hours.

How is cannabinoid hyperemesis syndrome diagnosed?

Cannabinoids are compounds in the Cannabis sativa plant that bind to cannabinoid receptors in your brain, spinal cord, gastrointestinal tract and other body tissues. Examples of cannabinoids include tetrahydrocannabinol (THC) and cannabidiol (CBD). The term “marijuana” typically refers to the tobacco-like preparations is cannabidiol addictive of the leaves and flowers of the plant cannabis sativa. The active ingredient is believed to be tetrahydrocannabinol (THC), which is also responsible for intoxication. THC concentrations vary with climate, soil, and cultivation techniques. Additionally, THC absorption varies with the route of administration.

Scientists put the stopwatch on cannabis intoxication – University of Sydney

Scientists put the stopwatch on cannabis intoxication.

Posted: Mon, 12 Apr 2021 07:00:00 GMT [source]

What are the possible complications of cannabinoid hyperemesis syndrome?

CBD is a potent inhibitor of the CYP450 enzymes, CYP3A4 and CYP2C19. These hepatic enzymes metabolize clobazam and sodium valproate, which were prescribed in over half of the patients in the three main epilepsy studies included in the meta-analysis [17, 18, 27]. Inhibition of CYP2C19 can increase the levels of clobazam’s metabolite, N-desmethylclobazam, by two- to seven-fold, which has a significant sedative effect [28]. In a recent experimental study, even very high acute doses of CBD (1.5 and 4.5 g orally) had limited effects on alertness, suggesting that CBD alone is not usually sedative [29]. Increased N-desmethylclobazam levels could also account for the increased odds of pneumonia in epileptic patients taking CBD, as this increases the risk of sedation, respiratory depression and aspiration [30]. Again, these events only occurred in patients prescribed high doses of CBD (10–20 mg/kg/day).


Cannabis Hyperemesis Syndrome (CHS)

cannabidiol toxicity symptoms


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