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Alcohol, Headaches and Hangovers

What's New and What You Can Do

The spirits in a bottle can quickly ruin the spirit of a holiday. Some people just drink too much, and some people drink only a bit but pay a heavy price. For 35 years, I have encountered people with big headaches and little headaches, simple headaches and serious headaches, once-a-year headaches and daily headaches.

Joel Saper M.D.
Dr. Joel Saper founded and directs the Michigan Head-Pain and Neurological Institute in Ann Arbor, Mich.

I have met people whose headaches result from just the smell of a beer and others whose headaches occur only after drinking a case of beer.

Here is some new information and some tips to help you take the spirits out of the bottle without taking the spirit out of the holidays.

Headaches From the Bottle

There are two major kinds of headaches that might appear after a night -- or afternoon -- of drinking. The first I call the soon-after headache, which occurs within one to four hours of drinking some but not all alcoholic beverages.

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The other type of headache is the morning-after headache that occurs several hours after drinking has ceased and is usually part of the hangover.

The Soon-After Headache

Most people who experience the soon-after headache have had headaches in the past, usually migraine or related headaches. These headaches are actually genetic -- the brain biology changes so that it overreacts to both internal (hormonal, for example) or external changes, such as a swig from the bottle.

Ironically, even though alcohol is the intoxicating substance in these beverages, it is not usually the source of the headache. Certain nonalcoholic ingredients are more likely to induce the headache attack than alcohol itself.

Since brands vary in the amounts and types of these ingredients, some drinks are more likely than others to produce the headache.

Curiously, I have treated several individuals who can drink one brand of beer without developing a headache but can't stand even a sip of any other brand. Many people can drink white wine without developing a headache but will invariably experience a severe headache when they drink red wine.

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