Volume 21 • Issue 2 • 1000e116
J Psychiatry, an open access journal
ISSN: 2378-5756
Open Access
Uddin and Amran, J Psychiatry 2018, 21:2
DOI: 10.4172/2378-5756.1000e116
Editorial Open Access
Journal of Psychiatry
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ISSN: 2378-5756
*Corresponding author: Md. Sahab Uddin, Department of Pharmacy,
Southeast University, Dhaka, Bangladesh, Tel: +880 1710220110; E-mail: msu_
neuropharma@hotmail.com, msu-neuropharma@hotmail.com
Received: January 23, 2018; Accepted: January 23, 2018; Published: January
29, 2018
Citation: Uddin MS, Amran MS (2018) Cannabinoid Hyperemesis: An Erratic
Syndrome Linked with Cannabis Abuse. J Psychiatry 21: e116. doi:10.4172/2378-
5756.1000e116
Copyright: © 2018 Uddin MS, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited
Cannabinoid Hyperemesis: An Erratic Syndrome Linked with Cannabis Abuse
Md. Sahab Uddin
1
* and Md. Shah Amran
2
1
Department of Pharmacy, Southeast University, Dhaka, Bangladesh
2
Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, Bangladesh
Editorial
Cannabinoid hyperemesis syndrome (CHS) is characterized by
chronic cannabis use, recurrent episodes of intractable nausea and
vomiting, frequent hot bathing and abdominal pain [1]. Te syndrome
was frst described by Allen et al. [2], and later Sontineni et al. [3]
who proposed abridged clinical diagnostic criteria. Simonetto et al.
by appraising all PubMed indexed journals with case reports and case
series on CHS, reported a case series of 98 patients [4]. Tis study
confrmed the previously stated outcomes. Te researchers avowed that
CHS should be measured in younger patients with chronic cannabis
use and repeated nausea, vomiting, as well as pain in the abdominal.
Amid illicit drug, cannabis is the utmost typically used this drug in the
world [5].
In line with the 2015 National Survey on Drug Use and Health,
22.2 million people have used cannabinoids in the past month [6].
Te prevalence of use is higher in men than women, a gender gap
that extended in the years 2007 to 2014 (Figure 1) [7]. Te number of
people afected is not diaphanous as of 2015 [8]. Cannabis use is linked
with copious acute and chronic adverse efects as stated earlier such
as vomiting, followed by cyclic vomiting syndrome, intense feelings
of nausea and accompanying symptoms, abdominal discomfort and
compulsive hot bathing behaviour [3]. Habboushe and Sedor, reported
that CHS can lead to snags, for example, acute renal failure (ARF) [9].
Te pathogenesis of CHS is covert, several mechanistic theories
attempting to explain the exact pathology. Tese notions fall into two
themes: dose reliant accumulation of cannabinoids and associated
efects of cannabinoid toxicity; and the functionality of cannabinoid
receptors in the brain and predominantly in the hypothalamus that
controls body temperature and the digestive system [10]. Chang and
Windish ofer an outline of substantiating proof for these theories;
however, the mechanisms by which cannabis engender controls nausea
and the adverse magnitudes of chronic cannabis toxicity remain cryptic
[11].
Cannabinoid binds to two kinds of G-protein coupled cannabinoid
receptors, CB
1
and CB
2
that act by inhibiting adenylate cyclase [12].
In conjunction with the discovery of the CB
1
and CB
2
receptors has
been the identifcation of endogenous arachidonic acid derivatives
that bind to these receptors called endogenous cannabinoids, or
endocannabinoids [13]. Te therapeutic potential of cannabinoids has
been identifed and these compounds are utilized as antiemetics for
controlling nausea and vomiting as well as in the progressive phases
of ailments such as cancer and acquired immune defciency syndrome
[14].
Te acute incidents of CHS typically last for 24 to 48 h and the
cessation of use is efective. Generally, 1 to 3 months is required for
perfect recovery [15]. Numerous medications for nausea and vomiting
are inefective for this syndrome. Chen and McCarron stated that relief
has been reported with lorazepam and haloperidol [16]. Furthermore,
evaluating for dehydration owing to vomiting and hot showers is
imperative as it can lead to ARF and resolved with intravenous
hydration [16].
CHS is a novel and under-documented clinical entity. Advanced
studies are obligatory to control this disease prevalence and its other
epidemiological features, natural antiquity as well as pathophysiology.
Further treatments are enforced and exertions to stop cannabis abuse
are supreme.
Acknowledgements
The authors wish to thank the anonymous reviewer(s)/editor(s) of this article
for their constructive reviews.
Competing Interests
The authors state no competing interests.
References
1. Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA (2017) Cannabinoid
hyperemesis syndrome: Diagnosis, pathophysiology, and treatment-a
Figure 1: Cannabinoids are the illicit drug most likely to be used by teenagers
and its abuse lead to cannabinoid hyperemesis syndrome. The treatment of this
syndrome is supportive and emphases on ceasing cannabis use.