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Patients with cannabis hyperemesis syndrome experience recurrent/protracted nausea/vomiting. Cases of cannabis hyperemesis syndrome may increase as cannabis use becomes more common in the United States.
A randomized control trial (triple-blind) was conducted to compare haloperidol (0.05 or 0.1 mg/kg) IV or ondansetron 8 mg IV. Primary outcome was reduction of abdominal pain and nausea from baseline (on a 10 cm visual analog scale) 2 hours after treatment.
Results
- 33 subjected were randomized to haloperidol (n=13) and ondansetron (n=17)
- 30 used 1.5 gm/day since 19 years of age.
- Haloperidol was superior to ondansetron
- 2.3 cm difference in pain and nausea
- Less use of rescue antiemetics (31% vs. 59%)
- Shorter time to ED departure (3.1 hours vs. 5.6 hours)
Conclusion
- In this small trial, haloperidol (0.05 or 0.1 mg/kg IV) was superior to ondansetron (8 mg IV) in the treatment of acute cannabis associated hyperemesis
References
Ruberto AJ. et al. Intravenous haloperidol versus ondansetron for cannabis hyperemesis syndrome (HaVOC): a randomized controlled trial. Annals of Emergency Medicine. Nov 2020
https://doi.org/10.1016/j.annemergmed.2020.08.021