Practitioner’s CornerTreatment of Cannabinoid Hyperemesis With Olanzapine: A Case SeriesHsu, Jennifer DO; Herrmann, Zachary DO; Kashyap, Saurabh DO; Claassen, Cynthia PhDAuthor Information HSU, HERRMANN, KASHYAP, CLAASSEN: Department of Psychiatry, John Peter Smith Hospital, Fort Worth, TX C.C. has received advisory or consulting fees from the following organizations: the Educational Development Corporation on behalf of the National Suicide Prevention Resource Center, the British National Health Service, the National Institute of Mental Health (Washington, DC), the Hong Kong Special Administrative Region (Hong Kong, China) Department of Health, and LivaNova Inc. She has also received study-related support from Alkermes, Roche, NeuroRx, and Janssen Pharmaceutical Companies. The remaining authors declare no conflicts of interest. Please send correspondence to: Jennifer Hsu, DO, 1500 South Main Street, Fort Worth, TX 76104 (e-mail: [email protected]). Journal of Psychiatric Practice: July 2021 - Volume 27 - Issue 4 - p 316-321 doi: 10.1097/PRA.0000000000000564 Buy Metrics Abstract The use and availability of cannabis for recreational and medical purposes has become more widespread with increased legalization. Adverse health outcomes of this increased use include cannabinoid hyperemesis syndrome (CHS), which is underrecognized in medical settings. Cessation of substance use is the recommendation of choice for the complete resolution of CHS. However, interventions that provide rapid relief may be necessary in treatment-refractory cases. Little evidence is available to guide care in these cases. Here we report 4 cases of treatment-refractory CHS, all of which remitted after treatment with olanzapine. Olanzapine is known to block multiple neurotransmitter receptors involved in nausea and vomiting in chemotherapy-induced nausea and vomiting. Outcomes of the cases reported here suggest that off-label use of olanzapine may be effective in the symptomatic treatment of refractory CHS and may be the preferred treatment in cases in which comorbid psychotic symptoms or agitation are present. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.