Alcohol Hangover - Mechanisms and Mediators

Hangovers are a frequent, though unpleasant, experience among people who drink to intoxication. Despite the prevalence of hangovers, however, this condition is not well understood scientifically. Multiple possible contributors to the hangover state have been investigated, and researchers have produced evidence that alcohol can directly promote hangover symptoms through its effects on urine production, the gastrointestinal tract, blood sugar concentrations, sleep patterns, and biological rhythms. In addition, researchers postulate that effects related to alcohol’s absence after a drinking bout (i.e., withdrawal), alcohol metabolism, and other factors (e.g., biologically active, nonalcohol compounds in beverages; the use of other drugs; certain personality traits; and a family history of alcoholism) also may contribute to the hangover condition. Few of the treatments commonly described for hangover have undergone scientific evaluation. KEY WORDS: post AOD intoxication state; symptom; urinalysis; gastrointestinal disorder; hypoglycemia; sleep disorder; circadian rhythm; ethanol metabolite; disorder of fluid or electrolyte or acid-base balance; nutrient intake; headache; vomiting; neurotransmitter receptors; congenors; multiple drug use; personality trait; family AODU (alcohol and other drug use) history; drug therapy; literature review

The British writer William Hickey wrote these words in the year 1768, vividly describing the aftermath of a bout of heavy alcohol drinking—an experience commonly referred to as a “hangover.” Similar descriptions of hangovers appear in the writings of ancient Egypt and Greece as well as in the Old Testament. No doubt, prehistoric people also experienced hangovers soon after they discovered alcohol.

Despite its long history, however, hangover has received relatively scant formal attention from researchers. Little is known about the physiology underlying the hangover condition. For example, it is unclear whether hangover signs and symptoms are attributable to alcohol’s direct effects on the body, its aftereffects, or a combination of both. Similarly, investigators are uncertain about the degree to which hangover affects a person’s thinking and mentally controlled motor functions, a question with serious implications for activities such as job performance and driving. In addition, researchers know little about hangover prevention and treatment. Although folk remedies for hangovers abound, their efficacy in reducing the intensity and duration of a hangover has not received systematic study. In fact, some researchers and clinicians question whether finding an effective treatment for hangovers is desirable, given that the hangover experience may deter some people from engaging in subsequent episodes of heavy drinking.

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