Alcohol and Migraine: What Should We Tell Patients?
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Alcoholic drinks are a migraine trigger in about one third of patients with migraine in retrospective studies on trigger factors. Many population studies show that patients with migraine consume alcohol in a smaller percentage than the general population. Moreover, research has shown a decreased prevalence of headache with increasing number of alcohol units consumed. The classification criteria of alcohol-related headaches remain problematic. We discuss the role and mechanism of action of alcohol or other components of alcoholic drinks in relation to alcohol-induced headache. In accordance with data from a recent prospective study, we believe that reports overestimate the role of alcohol, as well as other foods, in the triggering of migraine. If a relationship between the intake of alcohol and the migraine attack is not clear, a small dose of alcohol is not contraindicated either for enjoyment or its protective effect on cardiovascular disease.
KeywordsHangover Migraine Headache Alcohol Headache classification criteria Trigger factors Wine Serotonin Serotonin release Alcohol consumption Congeners Vasodilatation Lifestyle
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- 2.Clifford Rose F. Food and headache. Headache Q. 1997;8:319–29.Google Scholar
- 8.Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2004;24 suppl 1:1–160.Google Scholar
- 9.Olesen J, Steiner T, Bousser M-G, et al. Proposals for new standardized general diagnostic criteria for the secondary headaches. Cephalalgia. 2009;12:1131–6.Google Scholar
- 27.•• Rohsenow DJ, Howland J. The role of beverage congeners in hangover and other residual effects of alcohol intoxication: a review. Curr Drug Abuse Rev. 2010;3:76–9. This is a review of the few studies that assessed the effects of drinks with high or low content of congeners on hangover. PubMedCrossRefGoogle Scholar
- 28.Damrau F, Liddy E. Hangovers and whisky congeners: comparison of whisky with vodka. J Nat Med Assoc. 1960;52:262–5.Google Scholar
- 35.• Nicoletti P, Trevisani M, Manconi M, et al. Ethanol causes neurogenic vasodilation by TRPV1 activation and CGRP release in the trigeminovascular system of the guinea pig. Cephalalgia 2008;28:9–17. This article asserted that a vasodilatation of meningeal vessels by CGRP release may be relevant to the mechanism by which alcohol triggers migraine. PubMedCrossRefGoogle Scholar
- 38.• Spaak J, Merlocco AC, Soleas GJ, et al. Dose-related effects of red wine and alcohol on hemodynamics, sympathetic nerve activity, and arterial diameter. Am J Physiol Heart Circ Physiol. 2008;294:H605–12. In this article, some of the cardiovascular effects of ethanol and wine were characterized and compared in the same individual.PubMedCrossRefGoogle Scholar
- 49.• Schurks M, Rist PM, Bigal ME, et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ 2009:339. doi: 10.1136/bmj.b3914. This is a comprehensive and good review on the association between migraine and cardiovascular disease.