Abstract
Cyclic vomiting syndrome (CVS) comprises four distinct phases. This chapter addresses especially challenging components of CVS care—aborting symptoms in the prodromal or early emetic phase and providing supportive treatment for patients with vomiting unresponsive to abortive therapy if needed. Available treatments which can be self-administered at home for this purpose include antiemetics (including ondansetron and aprepitant), triptans (including nasal or injectable sumatriptan), and agents with combined antiemetic and sedating actions. Selected patient populations including pregnant women or individuals who are cannabis users warrant special consideration. When needed, protocols have been devised for emergency department and inpatient management of refractory cases. Future research should address new therapies which act on novel pathways in CVS pathogenesis.
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