大麻素呕吐综合征的治疗：会诊-联络精神科医生的系统回顾和治疗算法。

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-10-17 DOI:10.1016/j.genhosppsych.2025.10.012

Jennifer Hsu , Saurabh Kashyap , Cheryl Hurd , Lauren McCormack , Zachary Herrmann , Ann C. Schwartz , Joshua Jackson , Dustin DeMoss

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引用次数: 0

摘要

背景：大麻素呕吐综合征（CHS）是一种周期性呕吐综合征，与慢性大麻使用有关，通常对止吐药有抗性。尽管疑似CHS的发病率越来越高，但有关其治疗的文献有限，也没有既定的治疗指南。目的：为了建立咨询联络（C-L）精神科医生管理CHS的治疗指南，作者使用系统评价和荟萃分析（PRISMA）指南的首选报告项目系统地回顾了现有的药物治疗策略文献。根据综述的结果，作者提出了一种治疗CHS的算法。方法：我们检索PubMed， PyschINFO & PsychARTICLES， Embase和Web of Science从成立到2021年7月，以确定描述CHS治疗的文献。我们纳入了描述CHS治疗的患者水平数据可用的CHS病例。如果患者的恶心、呕吐和洗热水澡的冲动得到缓解，药物治疗被认为是有益的。排除标准的非独立评价有助于减少文献的个体偏倚。结果：作者确定了34篇符合条件的文章，包括63例个案。在这些文章和病例中，辣椒素乳膏、抗精神病药物和苯二氮卓类药物被报道比其他更常用的止吐药，如异丙嗪、昂丹西琼和甲氧氯普胺更有效地改善CHS。结论：对CHS的治疗策略进行研究可以提供更有效的治疗，同时为进一步的治疗研究提供基础。该算法旨在帮助在一般医疗环境中协助管理CHS患者的C-L精神科医生建立治疗策略。本研究的目的是为在一般医疗环境中管理CHS患者的C-L精神科医生建立循证治疗指南。认识到该算法基于病例报告的局限性，增加了在该领域进一步研究的必要性。报名：普洛斯彼罗（https://www.crd.york.ac.uk/PROSPERO/view/CRD42021254888）注册号CRD42021254888。

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Treatment of cannabinoid hyperemesis syndrome: A systematic review and treatment algorithm for consultation-liaison psychiatrists

Background

Cannabinoid Hyperemesis Syndrome (CHS) is a cyclical vomiting syndrome associated with chronic cannabis use and is often resistant to anti-emetics. Despite increasing incidence of suspected CHS, literature regarding its treatment is limited, and there are no established treatment guidelines.

Objectives

With the goal of establishing treatment guidelines for consultation-liaison (C-L) psychiatrists managing CHS, the authors systematically reviewed existing literature for pharmacologic treatment strategies using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. With the results of the review, the authors propose a treatment algorithm for CHS.

Methods

We searched PubMed, PyschINFO & PsychARTICLES, Embase, and Web of Science from inception to July 2021 to identify literature describing treatment of CHS. We included cases of CHS where patient-level data describing the treatment of CHS was available. Pharmacologic treatments were considered beneficial if the patient's nausea, hyperemesis, and urge to take hot showers resolved. Non-independent review of exclusion criteria assisted in reducing individual bias of the literature.

Results

The authors identified 34 eligible articles, consisting of 63 individual cases. Among these articles and cases, capsaicin cream, antipsychotics, and benzodiazepines were reported to improve CHS more effectively than other, more frequently used anti-emetics, such as promethazine, ondansetron, and metoclopramide.

Conclusion

An examination of treatment strategies for CHS can allow for more effective care while providing a foundation for further research in treatment. This proposed algorithm is designed to aid in establishing treatment strategies for C-L psychiatrists who assist with managing CHS for patients in general medical settings. The goal of this research is to establish evidence-based treatment guidelines for C-L psychiatrists who are managing patients with CHS in general medical settings. Recognizing the limitations of this algorithm being based on case reports adds to the necessity of further research in this area.

Registration

PROSPERO (https://www.crd.york.ac.uk/PROSPERO/view/CRD42021254888) registration number CRD42021254888.

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.