Low-dose metoclopramide-induced dystonia in cannabis withdrawal syndrome manifesting as intractable nausea and vomiting.

Cannabis withdrawal syndrome (CWS) presents with irritability, anxiety and sleep disturbances within a week of stopping cannabis use. This case highlights a young woman with a medical history of recurrent hospitalisations due to intractable nausea and vomiting related to heavy, prolonged cannabis use and acute dystonic reactions secondary to haloperidol. The patient presented with intractable nausea, vomiting and frequent hot bathing five days after her last cannabis use. She developed an acute dystonic reaction to low-dose metoclopramide, a commonly used antiemetic, potentially exacerbated by cannabis's inhibition of drug-metabolising enzymes. We also highlight key differences between CWS and cannabis hyperemesis syndrome (CHS).