A pilot randomized control trial of topical capsaicin as adjunctive therapy for nausea and vomiting of pregnancy

BACKGROUND: Nausea and vomiting is one of the most common complications of pregnancy, affecting 50% to 80% of pregnant persons. Moreover, despite its prevalence, it remains a challenging condition to treat. Treatment often involves oral and intravenous medications with potential side effects, particularly when taken in combination. Capsaicin cream is proven to decrease nausea and vomiting in cyclic vomiting syn-drome; however, its use has not been well studied among pregnant patients.OBJECTIVE: This study aimed to test the feasibility of the off-label use of capsaicin for the treatment of nausea and vomiting in pregnancy. STUDY DESIGN: This was a double-blinded randomized controlled trial of pregnant individuals in their first trimester of pregnancy seeking care at a tertiary care hospital for nausea and vomiting. Consenting participants were randomized to abdominal application of topical capsaicin vs placebo. All par-ticipants received intravenous hydration and metoclopramide. The primary outcome, total treatment time, was recorded for all participants. In addition, symptom severity was assessed every 30 minutes using a visual analog scale. Data were analyzed using the Wilcoxon rank-sum test for continuous variables and the Fisher exact test for binary variables.RESULTS: Of the 38 eligible individuals approached, 30 were random-ized. There was a trend toward decreased mean treatment time in the capsaicin group compared with the placebo group (79.9 vs 97.3 minutes; P=.1). There was no significant difference in visual analog scale scores at any time point between groups. Furthermore, capsaicin was well tolerated, with only 1 individual requesting the medication be removed.CONCLUSION: This study demonstrated that capsaicin is an accept-able treatment of nausea and vomiting in pregnancy and additional explo-rations of its use as treatment are feasible. A larger randomized controlled trial is needed to determine the efficacy of capsaicin in this population.

Automated summary

This study aimed to test the feasibility of using capsaicin for the treatment of nausea and vomiting in pregnancy. A randomized controlled trial was conducted on pregnant individuals in their first trimester. The results showed a trend towards decreased treatment time with capsaicin compared to placebo, but no significant difference in symptom severity. This study suggests that capsaicin is an acceptable treatment for nausea and vomiting in pregnancy, but further research is needed to determine its efficacy.