Endo- Phyto- and Synthetic-Cannabinoids and the Cannabinoid-Induced Hyperemesis Syndrome

Nissar A. Darmani* and Weixia Zhong

Endo- Phyto- and Synthetic-Cannabinoids and the Cannabinoid-Induced Hyperemesis Syndrome.

In this short review, the current status of the endocannabinoid system and the major cannabinoids produced in humans/animals, plants, and those manufactured in the laboratory will be elucidated. Synthetic
and phytocannabinoids produce their psychoactive effects via the activation of cannabinoids CB1 receptors. To date there is no report to demonstrate that administration of endocannabinoids can induce euphoria in humans.

A key indication for use of phyto- and synthetic cannabinoids in the clinic is for the prevention of chemotherapyinduced nausea and vomiting. However, the major psychoactive component of the marijuana plant, delta-9-tetrahydrocannabinol, as well as synthetic cannabinoid may also evoke vomiting in some patients.

In this review, we further discuss these gastrointestinal side-effects of cannabinoids which in some patients may lead to a more serious gastrointestinal condition known as the cannabinoid-induced hyperemesis syndrome. Lastly, we debate the
potential mechanisms underlying CHS and its prevention.

Cannabis refers to constituents of the plant Cannabis sativa, commonly known as marijuana. Cannabis has been used medically for thousands of years in Asian and Middle Eastern countries. During the mid-19th century, cannabis preparations were introduced in Europe and the United States.

Basic laboratory research on cannabis started in 1940’s2 leading to the isolation and chemical characterization of the major psychoactive constituent of marijuana plant, delta9-tetrahydrocannabinol in 1964. The pharmacological effects of Δ9 -THC can vary with dose, route of administration, user experience, and the setting of use. Marijuana intoxication can produce “a high” as well as changes in mood, perception and motivation. CHS was first reported in 2004 by Allen and co-workers.

Gastro Open J. 2017; SE(1): S1-S8. doi: 10.17140/GOJSE-1-101