Medical cannabis treatments for cyclic vomiting syndrome

Cyclic vomiting syndrome (CVS) is a rare condition that causes sudden, repeated episodes of feeling and being sick, followed by periods of feeling normal. Prescribed medical cannabis may help some eligible patients to manage the nausea, vomiting and anxiety often associated with the condition.

What is cyclic vomiting syndrome? 

Cyclic vomiting syndrome (CVS) is a disorder of the gut-brain axis that causes severe nausea and vomiting on an episode-by-episode basis, separated by periods where you feel completely fine.

Each of these episodes tends to follow a specific pattern: they’ll start at the same time of day, last a set amount of time and cause the same set of symptoms each time. 

Between attacks, most people then go back to feeling completely normal, which is what makes the condition so disruptive and difficult to predict.

These attacks can be brought on by certain triggers as well, including things like: 

• stress, anxiety or panic attacks

• feeling physically exhausted

• colds, allergies and infections

• certain foods and drinks, like alcohol, caffeine, cheese or chocolate

• hormonal changes

• going without food or drink over a long period

While CVS was once believed to only be a childhood condition, it’s now known to affect adults too. 

In fact, around 1% of adults in the UK are estimated to have CVS. And because it's still such a relatively unknown condition, many patients are left waiting up to six years before receiving an actual diagnosis.

Once CVS has been diagnosed, having the right treatment plan in place can help combat the symptoms and make life easier for patients to manage.

What symptoms does cyclic vomiting syndrome cause?

As its name suggests, the most common symptom of CVS is the vomiting it can lead to. These episodes can feel relentless when they occur, and will often follow a six-step pattern: 

1. A sudden feeling of sickness (nausea)

2. Starting to sweat

3. Going paler than normal

4. Trying to be sick (retching) 

5. Actually being sick (vomiting)

6. A period of feeling completely normal

But it’s not just your stomach that CVS can affect. The condition is also associated with a wide variety of other symptoms, such as: 

• feeling exhausted

• lack of appetite

• stomach cramps and pains

• diarrhoea

• dizziness 

• headaches 

The unpredictability of the condition may also impact other areas of your life, potentially leading to chronic pain, sleep disturbances and mental health issues. 

In fact, researchers have found that up to 84% of patients living with CVS also suffer from anxiety, while 78% have moderate-to-severe depression. 

What treatments are currently available for cyclic vomiting syndrome?

Conventional treatments for CVS have two main objectives: reducing the frequency of episodes and easing the symptoms that occur when they do.

Finding the right type of medicine for you will depend on several factors, including your age, the triggers that cause each of your episodes and the symptoms you’re experiencing.  

Here’s a brief overview of the treatments most commonly recommended to CVS patients: 

 

These treatments are usually very effective at both managing the symptoms of cyclic vomiting syndrome and making episodes easier to contain. But they don't work perfectly for everyone and, in some cases, can lead to certain side effects. 

To discover the impact that prescribed medical cannabis has had on some of our patients with CVS, head across to our dedicated patient stories page. 

Can medical cannabis treatment help with cyclic vomiting syndrome symptoms?

For some eligible patients, a medical cannabis prescription may help to manage certain symptoms associated with CVS, such as nausea, vomiting and anxiety. But it should only ever be taken under strict clinical guidance.

Medical cannabis doesn’t target the underlying mechanism that causes CVS episodes to happen, and shouldn’t be seen as a cure or standalone treatment. 

Where it may help is as an additional treatment to ease some of the symptoms that conventional treatments don’t always fully control. This is largely down to the two main active compounds it contains: tetrahydrocannabinol (THC) and cannabidiol (CBD).

• THC is psychoactive and is better known for its antiemetic (anti-sickness) properties, alongside its potential to ease symptoms like pain and anxiety

• CBD is non-intoxicating and has been shown to support mood, calm nausea, and promote an improved overall sense of wellbeing

Since CVS affects everyone differently, adopting a personalised, clinician-led approach is incredibly important when considering a medical cannabis prescription. 

By working closely with a specialist, they will be able to find the right balance of THC and CBD for your specific symptoms, at a dose that suits your day-to-day life.

How does the endocannabinoid system relate to cyclic vomiting syndrome?

The endocannabinoid system (ECS) is a complex cell-signalling network involved in regulating many bodily processes, including our perception of pain, ability to sleep and overall mood.

The system relies on two main receptors, handily known as CB1 and CB2:

• CB1 receptors are found mostly in the brain and central nervous system, including the areas that control feelings of nausea and the vomiting reflex

• CB2 receptors are largely found within immune cells and peripheral tissues, where they help regulate inflammation

The ECS is particularly relevant for cyclic vomiting syndrome because of its role in the brain-gut axis, the communication network between your brain and stomach. 

Researchers believe cannabinoids may have a role in the signalling involved in nausea and vomiting by acting on CB1 receptors in the brain stem. 

The full picture isn’t 100% clear yet though, and research is very much still ongoing. So, watch this space.

What does research say about medical cannabis and cyclic vomiting syndrome?

When searching for research into the specific relationship between medical cannabis and CVS, you’re likely to come up short. 

This is because most studies over recent years have explored the more general impact of cannabinoids, rather than CVS itself, focusing mainly on how they may help to ease symptoms like nausea and interact with the gut-brain axis.

Here’s a quick summary of the most relevant recent findings:

 

What do real-life patients think about the impact of prescribed medical cannabis on cyclic vomiting syndrome? Take a look at the results of our largest survey of active UK medical cannabis patients to find out.

What forms of Releaf medical cannabis can be prescribed for cyclic vomiting syndrome?

If you’re eligible to receive prescribed medical cannabis for cyclic vomiting syndrome, your consultant will work with you to determine the right format for you to take. 

The main forms of prescribed medical cannabis we can provide include: 

• oils

• capsules

• pastilles 

• vaporised dried flower 

• THC vapes

While you will be able to discuss your preferred method of administration with your consultant, the best format will ultimately depend on your symptoms, medical history, lifestyle and overall treatment goals. 

Take a look at our knowledge hub to discover detailed guides on each type of prescribed medical cannabis, and the different medical cannabis strains available. 

Am I eligible for UK medical cannabis treatment for cyclic vomiting syndrome?

Eligibility for prescribed medical cannabis varies on a patient-by-patient basis and, in the UK, can only be approved by a specialist at a CQC-regulated private clinic. 

For cyclic vomiting syndrome specifically, this is one of many approved conditions that medical cannabis can be prescribed for, after the UK government updated the law back in November 2018. 

However, you’ll need to meet strict eligibility criteria based on your medical history, symptoms and diagnosis to qualify for treatment: 

 

How does the Releaf prescription process work? 

If you meet the eligibility criteria outlined above, our world-class clinical team will be able to assess whether a medical cannabis prescription could help as part of your wider treatment plan. 

During an initial consultation with us, your consultant will discuss the impact of your condition in more detail, asking you about the specific symptoms you experience during each episode, and any other treatments you currently take. 

If you’re deemed eligible to become a Releaf patient, you’ll receive access to a wide variety of options and benefits, including:

• Free consultations, prescription fees and delivery via a Releaf+ membership

• Patient-focused legal support through Releaf Protect

• Personalised travel certificates

• Your very own medical cannabis card 

Our medical cannabis eligibility checker is the easiest way to find out whether you're eligible. It's free, only takes 30 seconds, and may be your first step towards finding relief.

FAQs on medical cannabis for cyclic vomiting syndrome

If you've got more questions about medical cannabis and cyclic vomiting syndrome, we're here to help. Here are some of the questions our consultants are asked about most often.

What is the difference between cyclic vomiting syndrome and cannabinoid hyperemesis syndrome?

While CVS and cannabinoid hyperemesis syndrome may look very similar in terms of the symptoms they’re associated with, the underlying causes are very different. 

CVS happens independently of cannabis, affecting both children and adults alike. 

On the other hand, cannabinoid hyperemesis syndrome is a condition triggered by heavy, long-term cannabis use, which tends to ease once cannabis is stopped. 

This is why it’s so important for a specialist to review your full medical history and diagnosis before deciding whether prescribed medical cannabis is a suitable treatment.

Can medical cannabis stop a cyclic vomiting syndrome episode once it has started?

Medical cannabis can’t offer a guaranteed way to stop the episodes of CVS in the same way as more conventional treatments can. But taking it may help to ease the severity of nausea and vomiting for certain people. 

Which medical cannabis format works best when I cannot swallow during an episode?

If you struggle to swallow when experiencing a CVS episode, taking an inhaled form of medical cannabis, like vaporised dried flower or a THC vape, may be more practical and effective. 

That said, you should always speak to a specialist for tailored advice, working with your consultant to find a dosage and format that suits your specific needs. 

Releaf - let's rethink healthcare