{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:24:24Z","timestamp":1793856264448,"version":"4.6.1"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:00:00Z","timestamp":1793750400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cannabinoid hyperemesis syndrome (CHS) is an increasingly frequent emergency department (ED) presentation. Although ondansetron is commonly used, emerging evidence suggests haloperidol and droperidol may provide more effective symptom control. Robust comparative effectiveness data, particularly regarding short\u2010term ED recidivism, remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective cohort study using the TriNetX Research Network from 2014 to 2024. Adults presenting to the ED with vomiting\u2010related and cannabis\u2010related ICD\u201010 diagnoses who received haloperidol, droperidol, or ondansetron during the index encounter were included. Patients with alternative causes of vomiting or major confounding conditions were excluded. Propensity\u2010score matching was performed for three pairwise comparisons: haloperidol versus ondansetron, droperidol versus ondansetron, and droperidol versus haloperidol. The primary outcome was 72\u2010h ED recidivism. Secondary outcomes included 72\u2010h hospital admission, 7\u2010day ED recidivism, and coded adverse events. Multivariable Cox proportional hazards modeling evaluated independent predictors of 72\u2010h ED recidivism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, haloperidol was associated with lower 72\u2010h ED recidivism compared with ondansetron (8.2% vs. 15.1%; OR 0.50, 95% CI 0.41\u20130.62;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Droperidol was also associated with lower 72\u2010h ED recidivism compared with ondansetron (7.4% vs. 14.0%; OR 0.49, 95% CI 0.32\u20130.76;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0014). Droperidol and haloperidol did not differ significantly in 72\u2010h ED recidivism (7.5% vs. 9.8%; OR 0.75, 95% CI 0.47\u20131.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.23). In the multivariable model, haloperidol (HR 0.62, 95% CI 0.49\u20130.79) and droperidol (HR 0.68, 95% CI 0.56\u20130.83) were independently associated with lower return risk, whereas ondansetron was not. Coded adverse events were rare across all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large multicenter cohort, haloperidol and droperidol were associated with lower short\u2010term ED recidivism than ondansetron among adults meeting a suspected CHS phenotype. These findings support prospective studies evaluating haloperidol and droperidol for ED management of CHS, including optimal dosing, route, medication sequencing, discharge treatment, and safety monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70436","type":"journal-article","created":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:24:43Z","timestamp":1793852683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Haloperidol, Droperidol, and Ondansetron for Cannabinoid Hyperemesis Syndrome in the Emergency Department"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9905-7139","authenticated-orcid":false,"given":"Joseph","family":"O\u2019Brien","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Denver Health Medical Center Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayher","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Colorado, Anschutz Medical Campus Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-1669","authenticated-orcid":false,"given":"Joseph","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado, Anschutz Medical Campus Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-4831","authenticated-orcid":false,"given":"Ryan","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado, Anschutz Medical Campus Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Rague","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado, Anschutz Medical Campus Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,11,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/PHAR.1931"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.14309\/AJG.0000000000002216"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rgmx.2024.06.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/S13181\u2010016\u20100595\u2010Z"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/HEAD.14073"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/S10286\u2010018\u20100506\u20102"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/NMO.13604"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ACEM.14911"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000000157"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000732"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2025.2516128"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S473627"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2018.1564324"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3122\/JABFM.2021.04.200586"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ADD.16693"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/S42238\u2010023\u201000203\u2010X"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/BCR\u20102023\u2010256921"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.45310"}],"container-title":["Academic 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