A Pilot Randomized Control Trial of Topical Capsaicin as Adjunctive Therapy for Nausea and Vomiting of Pregnancy [ID: 1376219

Abstract

INTRODUCTION: Nausea and vomiting is one of the most common complications of pregnancy affecting 50–80% of pregnant persons and despite its prevalence remains a challenging condition to treat. Therapy often involves oral and IV medications with potential side effects, particularly when taken in combination. Capsaicin cream is proven to decrease nausea and vomiting in cyclic vomiting syndrome, however has not been well studied among pregnant patients. We conducted a pilot randomized controlled trial (RCT) to test the acceptability and feasibility of the off-label use of capsaicin for treatment of nausea and vomiting in pregnancy. METHODS: Patients were recruited during triage evaluation for nausea and vomiting. Institutional review board approval was obtained prior to enrollment. Consenting participants were randomized to abdominal application of topical capsaicin versus placebo. All participants received intravenous hydration and metoclopramide. The primary outcome, total treatment time, was recorded for all participants. Additionally, symptom severity was assessed every 30 minutes using a visual analogue scale. RESULTS: Of the 38 eligible individuals approached, 30 were randomized. There was a trend towards decreased mean treatment time in the capsaicin group compared to placebo (79.9 versus 97.3 minutes, P=.1). There were no significant differences in VAS scores at any time point between groups. Furthermore, capsaicin was well tolerated, with only one individual requesting the medication be removed. CONCLUSION: This study demonstrates that capsaicin is an acceptable treatment for nausea and vomiting in pregnancy and additional explorations of its use as therapy are feasible. A larger RCT is needed to determine the efficacy of capsaicin in this population.