Question - Some have proposed the use of topical capsaicin for the symptomatic relief of symptoms in the cannabinoid hyperemesis syndrome (CHS). What is the proposed mechanism for the efficacy of capsaicin in this setting?
Answer: The cited reference notes “capsaicin binds to transient reception potential vanilloid-1 receptors (TRPV1) found widely throughout the body, often in proximity to CB-1 receptors and thus suggesting a functional interaction. Such areas include the medullary vomiting center and the GI tract. The TRPV1 receptors are also activated by low pH and high temperature and they may regulate release of substance P, an important mediator of nausea and emesis from sensory nerves. As such, TRPV1 receptors may play a teleological role in the efficacy of hot showers/baths for symptomatic relief of CHS”. (Richards JR et al. Pharmacologic treatment if cannabinoid hyperemesis syndrome: A systematic review. 2017 Pharmacotherapy 37(6): 725-734)