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. 2022;27(1):12-18.
doi: 10.5863/1551-6776-27.1.12. Epub 2021 Dec 22.

Cyclic Vomiting Syndrome in Pediatric Patients: A Review of Therapeutics

Emma M Tillman  1 , Emily M Harvath  2
Affiliations

Cyclic Vomiting Syndrome in Pediatric Patients: A Review of Therapeutics

Emma M Tillman et al. J Pediatr Pharmacol Ther. 2022.

Abstract

Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder that can present quite a challenge to clinicians caring for children with this complex disease. Different therapeutic interventions are recommended for prophylaxis and acute abortive therapy for a CVS attack. The aim of this review is to summarize therapeutic treatment recommendations from the 2008 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHN) Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome and discuss studies contemporary to this expert recommendation. After an extensive search of medical databases, 8 studies that evaluated therapeutic treatments for CVS were identified. Amitriptyline and cyproheptadine remain the standard of care for prophylaxis. Nutritional supplements such as carnitine and coenzyme Q10 have shown efficacy in decreasing episodes and severity in small studies with high tolerability among patients. The combination of ondansetron and sumatriptan are recommended for abortion of an acute vomiting episode, but other agents such as aprepitant and sedative agents can be considered when vomiting is refractory to initial treatments.

Keywords: child; familial cyclic vomiting syndrome; vomiting.

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Conflict of interest statement

Disclosures. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.

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