Cannabinoid Hyperemesis Syndrome
Conditions
Keywords
chs, cannabinoid hyperemesis syndrome, haldol, haloperidol
Brief summary
Patients diagnosed with cannabinoid hyperemesis syndrome that are safe for discharge from the emergency department will be sent an outpatient prescription for haloperidol to be used as needed at home. The study goal is to see if having this medication available helps to prevent return emergency department visits for recurrent or persistent symptoms.
Detailed description
Cannabinoid hyperemesis syndrome is a relatively new syndrome characterized by nausea, vomiting, and abdominal pain in the setting of excessive cannabis use. This clinical entity has become increasingly prevalent as the concentration of THC has increased in marijuana products over the past several decades. The symptoms have been treated successfully with several medications however the most efficacious appears to be dopamine antagonists such as haloperidol and droperidol. These dopamine antagonists have been used safely and successfully in the inpatient and emergency department settings to decrease the frequency and intensity of nausea, vomiting, and abdominal pain in patients suffering from cannabinoid hyperemesis syndrome. The investigators plan to evaluate haloperidol, a dopamine antagonist available as an oral formulation, as an option for outpatient management of these symptoms.
Interventions
DRUGHaloperidol
This intervention involves providing patients an outpatient prescription for as needed haloperidol to attempt to control symptoms of cannabinoid hyperemesis and to attempt to prevent return to the emergency department for that reason.
Sponsors
University of Illinois at Chicago
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patients must meet ALL of the following criteria: * Age ≥ 18 years * Primary ED complaints of acute or episodic nausea, vomiting, and/or abdominal pain * Self reported frequent cannabis use Patients must meet at least TWO of the following criteria: * History of recurrent, cyclical episodes of severe nausea and vomiting * Self-reported temporary symptom relief with hot showers or baths * Symptom onset or exacerbation following cannabis consumption
Exclusion criteria
* Patients with imaging or lab findings suggestive of an alternative etiology that would explain their symptoms * Already on dopamine agonist/antagonist therapy for another condition * Parkinson's disease * Lewy body dementia * Men with QTc \> 450 * Women with QTc \> 460 * Patients with documented allergy to haloperidol * Patients with known functional prolactinomas * Patients who are breastfeeding * Patients under the age of 18 * Patients who are pregnant * Patients who are in the prison system * Patients who are unable to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of return to the emergency department | 1 month | The investigators plan to measure the percentage of people who return to the emergency department for recurrence of symptoms attributable to cannabinoid hyperemesis syndrome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement in symptoms | 1 month | The investigators plan to report patient reported change in symptoms attributable to cannabinoid hyperemesis syndrome. The subjects will report change in their symptoms via a 5 point likert scale with 1 being no change in symptoms at all and 5 being complete resolution of symptoms. |
| Medication side effects | 1 month | The investigators plan to report the rate of patient reported side effects that are considered attributable to cannabinoid hyperemesis syndrome |
Countries
United States
Contacts
CONTACTMason A Bartman, MD
CONTACTWesley Eilbert, MD
PRINCIPAL_INVESTIGATORWesley Eilbert, MD
University of Illinois Health
Outcome results
None listed