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Published in: Current Pain and Headache Reports 3/2011

01-06-2011

Alcohol and Migraine: What Should We Tell Patients?

Authors: Alessandro Panconesi, Maria Letizia Bartolozzi, Leonello Guidi

Published in: Current Pain and Headache Reports | Issue 3/2011

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Abstract

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.
Literature
1.
go back to reference • Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007;27:394–402. This is the largest study on trigger factors of migraine. PubMedCrossRef • Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007;27:394–402. This is the largest study on trigger factors of migraine. PubMedCrossRef
2.
go back to reference Clifford Rose F. Food and headache. Headache Q. 1997;8:319–29. Clifford Rose F. Food and headache. Headache Q. 1997;8:319–29.
3.
go back to reference •• Panconesi A. Alcohol and migraine: trigger factor, consumption, mechanisms. A review. J Headache Pain 2008;9:19–27. This is a comprehensive review on the relationship between alcohol and migraine. PubMedCrossRef •• Panconesi A. Alcohol and migraine: trigger factor, consumption, mechanisms. A review. J Headache Pain 2008;9:19–27. This is a comprehensive review on the relationship between alcohol and migraine. PubMedCrossRef
4.
go back to reference Hauge AW, Kirchmann M, Olesen J. Trigger factors in migraine with aura. Cephalalgia. 2010;30:346–53.PubMedCrossRef Hauge AW, Kirchmann M, Olesen J. Trigger factors in migraine with aura. Cephalalgia. 2010;30:346–53.PubMedCrossRef
5.
go back to reference Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25:446–52.PubMedCrossRef Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25:446–52.PubMedCrossRef
6.
go back to reference •• Schurks M, Diener H-C. Cluster headache and lifestyle habits. Curr Pain Head Rep. 2008;12:115–21. This is a good review of alcohol consumption and smoking habits among patients with cluster headache.CrossRef •• Schurks M, Diener H-C. Cluster headache and lifestyle habits. Curr Pain Head Rep. 2008;12:115–21. This is a good review of alcohol consumption and smoking habits among patients with cluster headache.CrossRef
7.
go back to reference • Wober C, Brannath W, Schmidt K, et al. Prospective analysis of factors related to migraine attacks: the PAMINA study. Cephalalgia 2007:27:304–14. This is a large prospective study of migraine triggers. PubMedCrossRef • Wober C, Brannath W, Schmidt K, et al. Prospective analysis of factors related to migraine attacks: the PAMINA study. Cephalalgia 2007:27:304–14. This is a large prospective study of migraine triggers. PubMedCrossRef
8.
go back to reference Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2004;24 suppl 1:1–160. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2004;24 suppl 1:1–160.
9.
go back to reference 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. 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.
10.
12.
go back to reference Rasmussen BK, Olesen J. Symptomatic and non symptomatic headaches in a general population. Neurology. 1992;42:1225–31.PubMed Rasmussen BK, Olesen J. Symptomatic and non symptomatic headaches in a general population. Neurology. 1992;42:1225–31.PubMed
13.
go back to reference Howland J, Rohsenow DJ, Allensworth-Davies D, et al. The incidence and severity of hangover the morning after moderate alcohol intoxication. Addiction. 2008;103:758–65.PubMedCrossRef Howland J, Rohsenow DJ, Allensworth-Davies D, et al. The incidence and severity of hangover the morning after moderate alcohol intoxication. Addiction. 2008;103:758–65.PubMedCrossRef
14.
go back to reference Slutske WS, Piasecki TM, Hunt-Carter EE. Development and initial validation of the hangover symptoms scale: prevalence and correlates of hangover symptoms in college students. Alcohol Clin Exp Res. 2003;27:1442–50.PubMedCrossRef Slutske WS, Piasecki TM, Hunt-Carter EE. Development and initial validation of the hangover symptoms scale: prevalence and correlates of hangover symptoms in college students. Alcohol Clin Exp Res. 2003;27:1442–50.PubMedCrossRef
15.
go back to reference Kuster GW, da Silva AL Piraja, Aquino CH, et al. Frequency and features of delayed alcohol-induced headache among university students. Headache. 2006;46:688–91.PubMed Kuster GW, da Silva AL Piraja, Aquino CH, et al. Frequency and features of delayed alcohol-induced headache among university students. Headache. 2006;46:688–91.PubMed
16.
go back to reference Scher AI, Terwindt GM, Picavet HSJ, et al. Cardiovascular risk factors and migraine. The GEM population-based study. Neurology. 2005;64:614–20.PubMed Scher AI, Terwindt GM, Picavet HSJ, et al. Cardiovascular risk factors and migraine. The GEM population-based study. Neurology. 2005;64:614–20.PubMed
17.
go back to reference Aamodt AH, Stovner LJ, Hagen K, et al. Headache prevalence related to smoking and alcohol use. The Head-HUNT Study. Eur J Neurol. 2006;13:1233–8.PubMedCrossRef Aamodt AH, Stovner LJ, Hagen K, et al. Headache prevalence related to smoking and alcohol use. The Head-HUNT Study. Eur J Neurol. 2006;13:1233–8.PubMedCrossRef
18.
go back to reference • Kurth T, Schurks M, Logroscino G, Buring JE. Migraine frequency and risk of cardiovascular disease in women. Neurology 2009;73:581–8. This is a cohort study among participants in the Women’s Health Study. PubMedCrossRef • Kurth T, Schurks M, Logroscino G, Buring JE. Migraine frequency and risk of cardiovascular disease in women. Neurology 2009;73:581–8. This is a cohort study among participants in the Women’s Health Study. PubMedCrossRef
19.
go back to reference Molarius A, Tegelberg A, Ohrvik J. Socio-economic factors, lifestyle, and headache disorders—A population-based study in Sweden. Headache. 2008;48:1426–37.PubMedCrossRef Molarius A, Tegelberg A, Ohrvik J. Socio-economic factors, lifestyle, and headache disorders—A population-based study in Sweden. Headache. 2008;48:1426–37.PubMedCrossRef
20.
go back to reference Yokoyama M, Yokoyama T, Funazu K, et al. Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population. J Headache Pain. 2009;10:177–85.PubMedCrossRef Yokoyama M, Yokoyama T, Funazu K, et al. Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population. J Headache Pain. 2009;10:177–85.PubMedCrossRef
21.
go back to reference Fernandez-de-las-Penas C, Hernandez-Barrera V, Carrasco-Garrido P, et al. Population-based study of migraine in Spanish adults: relation to socio-demographic factors, lifestyle and co-morbidity with other conditions. J Headache Pain. 2010;11:97–104.PubMedCrossRef Fernandez-de-las-Penas C, Hernandez-Barrera V, Carrasco-Garrido P, et al. Population-based study of migraine in Spanish adults: relation to socio-demographic factors, lifestyle and co-morbidity with other conditions. J Headache Pain. 2010;11:97–104.PubMedCrossRef
22.
go back to reference Milde-Busch A, Blaschek A, Borggrafe I, et al. Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study. Headache. 2010;50:1104–14.PubMedCrossRef Milde-Busch A, Blaschek A, Borggrafe I, et al. Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study. Headache. 2010;50:1104–14.PubMedCrossRef
23.
go back to reference Garcia-Martin E, Martinez C, Serrador M, et al. Alcohol dehydrogenase 2 genotype and risk for migraine. Headache. 2010;50:85–91.PubMedCrossRef Garcia-Martin E, Martinez C, Serrador M, et al. Alcohol dehydrogenase 2 genotype and risk for migraine. Headache. 2010;50:85–91.PubMedCrossRef
24.
go back to reference Ramchandani VA, O’Connor S, Neumark Y, et al. The alcohol clamp: applications, challenges, and new directions—an RSA 2004 symposium summary. Alcohol Clin Exp Res. 2006;30:155–64.PubMedCrossRef Ramchandani VA, O’Connor S, Neumark Y, et al. The alcohol clamp: applications, challenges, and new directions—an RSA 2004 symposium summary. Alcohol Clin Exp Res. 2006;30:155–64.PubMedCrossRef
25.
go back to reference Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000;132:897–902.PubMed Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000;132:897–902.PubMed
26.
go back to reference Verster JC. The alcohol hangover—a puzzling phenomenon. Alcohol Alcohol. 2008;43:124–6.PubMed Verster JC. The alcohol hangover—a puzzling phenomenon. Alcohol Alcohol. 2008;43:124–6.PubMed
27.
go back to reference •• 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. PubMedCrossRef •• 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. PubMedCrossRef
28.
go back to reference Damrau F, Liddy E. Hangovers and whisky congeners: comparison of whisky with vodka. J Nat Med Assoc. 1960;52:262–5. Damrau F, Liddy E. Hangovers and whisky congeners: comparison of whisky with vodka. J Nat Med Assoc. 1960;52:262–5.
30.
go back to reference Perrino Jr AC, Ralevski E, Acampora G, et al. Ethanol and pain sensitivity: effects in healthy subjects using an acute pain paradigm. Alcohol Clin Exp Res. 2008;32:952–8.PubMedCrossRef Perrino Jr AC, Ralevski E, Acampora G, et al. Ethanol and pain sensitivity: effects in healthy subjects using an acute pain paradigm. Alcohol Clin Exp Res. 2008;32:952–8.PubMedCrossRef
31.
go back to reference Jochum T, Boettger MK, Burkhardt C, et al. Increased pain sensitivity in alcohol withdrawal syndrome. Eur J Pain. 2010;14:713–8.PubMedCrossRef Jochum T, Boettger MK, Burkhardt C, et al. Increased pain sensitivity in alcohol withdrawal syndrome. Eur J Pain. 2010;14:713–8.PubMedCrossRef
32.
go back to reference Ramchandani VA, Flury L, Morzorati SL, et al. Recent drinking history: association with family history of alcoholism and the acute response to alcohol during a 60 mg% clamp. J Stud Alcohol. 2002;63:734–44.PubMed Ramchandani VA, Flury L, Morzorati SL, et al. Recent drinking history: association with family history of alcoholism and the acute response to alcohol during a 60 mg% clamp. J Stud Alcohol. 2002;63:734–44.PubMed
33.
go back to reference Deng XS, Deitrich RA. Ethanol metabolism and effects: nitric oxide and its interaction. Curr Clin Pharmacol. 2007;2:145–53.PubMedCrossRef Deng XS, Deitrich RA. Ethanol metabolism and effects: nitric oxide and its interaction. Curr Clin Pharmacol. 2007;2:145–53.PubMedCrossRef
34.
go back to reference Gazzieri D, Trevisani M, Tarantini F, et al. Ethanol dilates coronary arteries and increases coronary flow via transient receptor potential vanilloid 1 and calcitonin gene-related peptide. Cardiovasc Res. 2006;70:589–99.PubMedCrossRef Gazzieri D, Trevisani M, Tarantini F, et al. Ethanol dilates coronary arteries and increases coronary flow via transient receptor potential vanilloid 1 and calcitonin gene-related peptide. Cardiovasc Res. 2006;70:589–99.PubMedCrossRef
35.
go back to reference • 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. PubMedCrossRef • 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. PubMedCrossRef
36.
go back to reference Dell’ Agli M, Buscialà A, Bosisio E. Vascular effects of wine polyphenols. Cardiovasc Res. 2004;63:593–602.CrossRef Dell’ Agli M, Buscialà A, Bosisio E. Vascular effects of wine polyphenols. Cardiovasc Res. 2004;63:593–602.CrossRef
37.
go back to reference Rathel TR, Samtleben R, Vollmar AM, Dirsch VM. Activation of endothelial nitric oxide synthase by red wine polyphenols: impact of grape cultivars, growing area and the vinification process. J Hypertens. 2007;25:541–9.PubMedCrossRef Rathel TR, Samtleben R, Vollmar AM, Dirsch VM. Activation of endothelial nitric oxide synthase by red wine polyphenols: impact of grape cultivars, growing area and the vinification process. J Hypertens. 2007;25:541–9.PubMedCrossRef
38.
go back to reference • 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.PubMedCrossRef • 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.PubMedCrossRef
39.
go back to reference Bau PF, Bau CH, Naujorks AA, Rosito GA. Early and late effects of alcohol ingestion on blood pressure and endothelial function. Alcohol. 2005;37:53–8.PubMedCrossRef Bau PF, Bau CH, Naujorks AA, Rosito GA. Early and late effects of alcohol ingestion on blood pressure and endothelial function. Alcohol. 2005;37:53–8.PubMedCrossRef
40.
go back to reference Stendel R, Irnich B, al Hassan AA, et al. The influence of ethanol on blood flow velocity in major cerebral vessels. A prospective and controlled study. Alcohol. 2006;38:139–46.PubMedCrossRef Stendel R, Irnich B, al Hassan AA, et al. The influence of ethanol on blood flow velocity in major cerebral vessels. A prospective and controlled study. Alcohol. 2006;38:139–46.PubMedCrossRef
41.
go back to reference Ashina M, Tfelt-Hansen P, Dalgaard P, Olesen J. Lack of correlation between vasodilatation and pharmacologically induced immediate headache in healthy subjects. Cephalalgia. 2010. doi:10.1177/0333102410394672. Ashina M, Tfelt-Hansen P, Dalgaard P, Olesen J. Lack of correlation between vasodilatation and pharmacologically induced immediate headache in healthy subjects. Cephalalgia. 2010. doi:10.​1177/​0333102410394672​.
42.
go back to reference • Panconesi A, Bartolozzi ML, Guidi L. Migraine pain: reflections against vasodilatation. J Headache Pain 2009;10:317–25. This article discusses the evidence against vasodilatation as migraine pain generator and some findings in support of central origin of the pain. PubMedCrossRef • Panconesi A, Bartolozzi ML, Guidi L. Migraine pain: reflections against vasodilatation. J Headache Pain 2009;10:317–25. This article discusses the evidence against vasodilatation as migraine pain generator and some findings in support of central origin of the pain. PubMedCrossRef
43.
go back to reference • Panconesi A. Serotonin and migraine: a reconsideration of the central theory. J Headache Pain 2008;9:267–76. This review critically evaluates studies concerning variation of peripheral and central serotonin parameters in patients with migraine. PubMedCrossRef • Panconesi A. Serotonin and migraine: a reconsideration of the central theory. J Headache Pain 2008;9:267–76. This review critically evaluates studies concerning variation of peripheral and central serotonin parameters in patients with migraine. PubMedCrossRef
44.
go back to reference Rothman RB, Baumann MH. Serotonin releasing agents. Neurochemical, therapeutic and adverse effects. Pharmacol Biochem Behav. 2002;71:825–36.PubMedCrossRef Rothman RB, Baumann MH. Serotonin releasing agents. Neurochemical, therapeutic and adverse effects. Pharmacol Biochem Behav. 2002;71:825–36.PubMedCrossRef
45.
go back to reference Baylen CA, Rosemberg H. A review of the acute subjective effects of MDMA/ecstasy. Addiction. 2006;101:933–47.PubMedCrossRef Baylen CA, Rosemberg H. A review of the acute subjective effects of MDMA/ecstasy. Addiction. 2006;101:933–47.PubMedCrossRef
46.
go back to reference Wilkins C, Sweetsur P, Girling M. Patterns of benzylpiperazine/trifluoromethylphenylpiperazine party pill use and adverse effects in a population sample in New Zealand. Drug Alcohol Rev. 2008;27:633–9.PubMedCrossRef Wilkins C, Sweetsur P, Girling M. Patterns of benzylpiperazine/trifluoromethylphenylpiperazine party pill use and adverse effects in a population sample in New Zealand. Drug Alcohol Rev. 2008;27:633–9.PubMedCrossRef
47.
go back to reference Thompson I, Williams G, Caldwell B, et al. Randomized double-blind, placebo-controlled trial of the effects of the ‘party pills’ BZP/TFMPP alone and in combination with alcohol. J Psychopharmacol. 2010;24:1299–308.PubMedCrossRef Thompson I, Williams G, Caldwell B, et al. Randomized double-blind, placebo-controlled trial of the effects of the ‘party pills’ BZP/TFMPP alone and in combination with alcohol. J Psychopharmacol. 2010;24:1299–308.PubMedCrossRef
48.
go back to reference • Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation 2007;116:1306–17. This excellent review discusses the relationship between alcohol and cardiovascular diseases. PubMedCrossRef • Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation 2007;116:1306–17. This excellent review discusses the relationship between alcohol and cardiovascular diseases. PubMedCrossRef
49.
go back to reference • 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. • 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.
50.
go back to reference •• Martin PR. Behavioral management of migraine headache triggers: learning to cope with triggers. Curr Pain Head Rep. 2010;14:221–7. This article suggests learning to cope with triggers instead of avoidance. A revision of studies on migraine triggers also was conducted. CrossRef •• Martin PR. Behavioral management of migraine headache triggers: learning to cope with triggers. Curr Pain Head Rep. 2010;14:221–7. This article suggests learning to cope with triggers instead of avoidance. A revision of studies on migraine triggers also was conducted. CrossRef
51.
go back to reference Cook CCH, Tarbet H, Ball D. Classically intoxicated: correlations between quantity of alcohol consumed and alcohol related problems in a classical Greek text. BMJ. 2007;335:1302–4.PubMedCrossRef Cook CCH, Tarbet H, Ball D. Classically intoxicated: correlations between quantity of alcohol consumed and alcohol related problems in a classical Greek text. BMJ. 2007;335:1302–4.PubMedCrossRef
52.
go back to reference Leone M, Vila C, McGown C. Influence of trigger factors on the efficacy of almotriptan as early intervention for the treatment of acute migraine in a primary care setting: the START study. Expert Rev Neurother. 2010;10:1399–408.PubMedCrossRef Leone M, Vila C, McGown C. Influence of trigger factors on the efficacy of almotriptan as early intervention for the treatment of acute migraine in a primary care setting: the START study. Expert Rev Neurother. 2010;10:1399–408.PubMedCrossRef
Metadata
Title
Alcohol and Migraine: What Should We Tell Patients?
Authors
Alessandro Panconesi
Maria Letizia Bartolozzi
Leonello Guidi
Publication date
01-06-2011
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 3/2011
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-011-0184-4

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