Acute Treatment of Adolescent Cannabinoid Hyperemesis Syndrome With Haloperidol, Lorazepam, and/or Capsaicin: A Single Institution Case Series.

IF 1.3 4区 医学 Q3 PSYCHIATRY
Jerry M Brown, Michael J Wilsey, Leila Dhana, Hannah Lonsdale
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引用次数: 0

Abstract

Cannabinoid hyperemesis syndrome (CHS), an under-recognized and seemingly paradoxical condition, arises in some adolescents and adults who chronically use cannabis. It presents acutely with intractable nausea, vomiting, and abdominal pain but standard antiemetic therapy leads to improvement for only a minority of patients. Randomized controlled trial evidence in adults indicates the superiority of haloperidol over ondansetron in alleviating the acute symptoms of CHS, but safe and effective treatment for adolescents with the disorder is currently unknown. The successful use of topical capsaicin has also been reported. We report a case series of 6 adolescent patients with CHS who presented to Johns Hopkins All Children's Hospital and were treated with haloperidol, lorazepam, and/or capsaicin. Four patients given 5 mg intravenous (IV) haloperidol and 2 mg IV lorazepam and 1 patient treated with 5 mg IV haloperidol and peri-umbilical topical capsaicin (0.025%) experienced full acute symptomatic relief. One patient, treated only with topical capsaicin, reported improvement of symptoms with some persistent nausea. Haloperidol/lorazepam, haloperidol/capsaicin, and topical capsaicin alone appear safe and effective in adolescents, but larger studies are required to confirm our findings.

氟哌啶醇、氯硝西泮和/或辣椒素急性治疗青少年大麻素类呕吐综合征:一个单一机构的病例系列。
大麻样充血综合征(CHS)是一种未被充分认识且看似矛盾的疾病,发生在一些长期使用大麻的青少年和成年人身上。它表现为急性顽固性恶心、呕吐和腹痛,但标准的止吐治疗只能使少数患者病情好转。在成人中进行的随机对照试验证据表明,氟哌啶醇在缓解CHS急性症状方面优于昂丹司琼,但目前尚不清楚对青少年CHS的安全有效治疗。局部应用辣椒素也有报道。我们报告了6名青少年CHS患者的一系列病例,他们在约翰斯·霍普金斯儿童医院接受了氟哌啶醇、劳拉西泮和/或辣椒素治疗。4名患者静脉注射5 mg氟哌啶醇和2 mg劳拉西泮,1名患者静脉滴注5 mg氟橄榄醇和脐周局部辣椒素(0.025%),急性症状完全缓解。一名患者仅接受局部辣椒素治疗,症状有所改善,并伴有一些持续恶心。氟哌啶醇/劳拉西泮、氟哌啶醇-辣椒素和局部辣椒素单独对青少年似乎是安全有效的,但还需要更大规模的研究来证实我们的发现。
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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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