![]() Received an antiemetic in the ED prior to randomizationĭiscontinued due to Adverse Events: 1 (5.9%) patient did not tolerate the treatment drug due to mild skin irritation Admission vs Discharge) need for rescue antiemetic medication within 30 and 120 min Secondary: Patient-reported nausea and percent change from baseline at 60 minutes complete relief of nausea (VAS = 0) disposition status (i.e. ![]() Primary: severity of nausea on a visual analog scale (VAS) of 0-10 assessed at 30 minutes following medication application The researchers also contacted patients after 30 days to assess for any additional skin-related adverse events and for any repeat ED or hospital visits.ĭirect treatment observation: up to 1 hour After the first 60 minutes, the patient was assessed for any additional skin-related adverse events over the entire course of the patient’s ED stay. Researchers remained at the bedside for the first 60 minutes to assess any immediate adverse events related to the study medication. Nausea was assessed using a validated visual analog scales (VAS). All patients continued to receive conventional therapy independent of study enrollment as determined by the treating physician. <18 years old pregnant patients allergy to capsaicin or hot peppers resolution of nausea prior to randomization outpatient use of prescription antiemetics within the past 24 hours (removed halfway through the trial) acute infectious or surgical abdominal conditions did not have cyclical vomiting had abdominal pain but no nausea doubted cannabis use was causing symptomsĮligible patients were randomized to receive either 5 g of topical 0.1% capsaicin cream or moisturizing cream (placebo). To evaluate the safety and effectiveness of the topical application of capsaicin cream as a treatment for vomiting due to suspected cannabinoid hyperemesis syndrome (CHS) in the emergency department (ED)Īdults ≥18 years presenting with suspected exacerbation of CHS and had active vomiting or nausea in the ED Randomized, double-blind, placebo-controlled pilot trial doi:10.1080/15563650.2019.1660783Ī Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome Efficacy and safety of topical capsaicin for cannabinoid hyperemesis syndrome in the emergency department. ![]() Wagner S, Hoppe J, Zuckerman M, Schwarz K, McLaughlin J. Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review. McConachie SM, Caputo RA, Wilhelm SM, Kale-Pradhan PB. Some reports described multiple capsaicin doses administered every four hours. A retrospective cohort study utilized capsaicin doses of 0.025% 0.075%, and 0.1%, but the 0.075% dose was the most frequently utilized (25/43 patients). The case series and case reports described a total of 12 patients who significantly improved following administration of capsaicin 0.075% cream however, some reports studied capsaicin doses of 0.025% and 1.5%. Capsaicin use was described as beneficial in all case series and case reports however, both retrospective cohort studies were unable to find a significant benefit for capsaicin on primary outcomes (emergency department length of stay). Ī systematic review selected 11 case reports and retrospective cohort studies in which capsaicin was used to reduce CHS-related symptoms. TRPV1 is a nociceptive receptor that is activated by extremely hot temperatures. These phases are still poorly understood but it is theorized that topical capsaicin, a transient receptor potential vanilloid 1 (TRPV1) receptor agonist, may be used as a first-line agent to effectively reduce symptoms. The recovery phase is the cessation of cannabis and the decline of related symptoms. ![]() The prodromal phase tends to be characterized by abdominal discomfort, fear of vomiting, and early morning nausea while the hyperemetic phase tends to be associated with frequent nausea, overwhelming episodes of vomiting, and a compulsive need to bathe in hot water for symptom relief. This condition is divided into 3 symptom-dependent phases, which include the prodromal, hyperemetic, and recovery phases. Cannabinoid Hyperemesis Syndrome (CHS) is characterized by cyclic episodes of nausea, vomiting, and abdominal pain, which are alleviated in most cases by hot showers, as reported by chronic cannabis users.
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