Concurrent Management of Adolescent Cannabinoid Hyperemesis Syndrome and Delirium With Haloperidol.

Hsu J.; Kotdawala M.; Priolo T. · Innovations in clinical neuroscience · 2026

**Background & Methods** This case report examines the hospital course of a 15-year-old female adolescent presenting with recurrent cannabinoid hyperemesis syndrome (CHS) complicated by concurrent delirium and behavioral disturbances. The patient received haloperidol as an off-label treatment for symptom management in the setting of traditional antiemetic failure. **Key Findings** • The patient presented with CHS symptoms including severe nausea, intense abdominal pain, compulsive bathing behavior, physical agitation, and delirium that were refractory to standard antiemetics (ondansetron, metoclopramide) and antinausea medications. • Initiation of low-dose haloperidol resulted in complete resolution of both gastrointestinal symptoms and behavioral/psychiatric manifestations within 6 days of treatment initiation, with subsequent hospital discharge. • Haloperidol demonstrated dual efficacy as both an antiemetic/antinausea agent and as treatment for concurrent delirium and agitation, addressing multiple symptom domains simultaneously. **Dosage & Administration** Not reported. The abstract references "standing low dose of haloperidol" without specifying the exact dose, frequency, or route of administration. **Safety & Adverse Effects** Not reported. The case report does not document adverse effects, tolerability concerns, or monitoring parameters during haloperidol treatment. **Evidence Quality** This is a single case report, representing the lowest level of clinical evidence (Level 5). Significant limitations include: (1) lack of control group or comparison conditions; (2) inability to establish causality between haloperidol and symptom resolution; (3) potential for reporting bias; (4) minimal baseline characterization of cannabis use patterns or CHS severity; (5) no mechanistic data provided regarding haloperidol's antiemetic properties in CHS pathophysiology; (6) lack of long-term follow-up data regarding symptom recurrence or relapse. The authors acknowledge that minimal literature exists on CHS management generally and "almost no evidence" exists examining CHS comorbid with delirium/agitation. While the case raises interesting clinical observations warranting further investigation, substantial additional research including controlled trials, dose-response studies, and mechanistic investigations would be required before haloperidol could be considered evidence-based treatment for CHS or CHS with concurrent delirium in adolescent populations.

More recent cannabis research