Summary: A new study reveals there is little evidence that substances that claim to reduce the effects of alcohol-induced hangovers work.
Source: Society for the Study of Addiction
A new systematic review has found only very low-quality evidence that substances claiming to treat or prevent alcohol-induced hangover work.
The researchers call for more rigorous scientific exploration of the effectiveness of these remedies for hangovers to provide practitioners and the public with accurate evidence-based information on which to make their decisions.
Numerous remedies claim to be effective against hangover symptoms; however, up-to-date scientific examination of the literature is lacking. To address this gap, a team of researchers from King’s College London and South London and Maudsley NHS Foundation Trust conducted a systematic review to consolidate and assess the current evidence for hangover treatments.
The study, published today by the scientific journal Addiction, assessed 21 placebo-controlled randomized trials of clove extract, red ginseng, Korean pear juice, and other hangover cures. Although some studies showed statistically significant improvements in hangover symptoms, all evidence was of very low quality, usually because of methodological limitations or imprecise measurements. In addition, no two studies reported on the same hangover remedy and no results have been independently replicated.
Of the 21 included studies, eight were conducted exclusively with male participants. The studies were generally limited in their reporting of the nature and timing of alcohol challenge that was used to assess the hangover cures and there were considerable differences in the type of alcohol given and whether it was given alongside food.
Common painkillers such as paracetamol or aspirin have not been evaluated in placebo controlled randomized controlled trials for hangover.
According to the researchers, future studies should be more rigorous in their methods, for example by using validated scales to assess hangover symptoms. There is also a need to improve the participation of women in hangover research.
Lead author Dr. Emmert Roberts says: “Hangover symptoms can cause significant distress and affect people’s employment and academic performance. Given the continuing speculation in the media as to which hangover remedies work or not, the question around the effectiveness of substances that claim to treat or prevent a hangover appears to be one with considerable public interest.
“Our study has found that evidence on these hangover remedies is of very low quality and there is a need to provide more rigorous assessment. For now, the surest way of preventing hangover symptoms is to abstain from alcohol or drink in moderation.”
The hangover cures assessed in this study included Curcumin, Duolac ProAP4 (probiotics), L-cysteine, N-Acetyl-L-Cysteine (NAC), Rapid Recovery (L-cysteine, thiamine, pyridoxine and ascorbic acid), Loxoprofen (loxoprofen sodium), SJP-001 (naproxen and fexofenadine), Phyllpro (Phyllanthus amarus), Clovinol (extract of clove buds), Hovenia dulcis Thunb. fruit extract (HDE), Polysaccharide rich extract of Acanthopanax (PEA), Red Ginseng, Korean Pear Juice, L-ornithine, Prickly Pear, Artichoke extract, ‘Morning-Fit’ (dried yeast, thiamine nitrate, pyridoxine hydrochloride, and riboflavin), Propranolol, Tolfenamic acid, Chlormethiazole, and Pyritinol.
The efficacy and tolerability of pharmacologically active interventions for alcohol‐induced hangover symptomatology: A systematic review of the evidence from randomised placebo‐controlled trials
To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover.
Systematic review of placebo-controlled randomised trials in healthy adults that evaluated any pharmacologically active intervention in the treatment or prevention of hangover. We searched Medline, Embase, PsycINFO and CENTRAL from database inception until 1st August 2021. The primary efficacy outcome was any continuous measure of overall hangover symptoms and the primary tolerability outcome the number of people dropping out due to adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework.
21 studies were included reporting on 386 participants. No two studies reported on the same intervention; as such, meta-analysis could not be undertaken. Methodological concerns and imprecision resulted in all studied efficacy outcomes being rated as very low quality. When compared with placebo, individual studies reported a statistically significant reduction in the mean percentage overall hangover symptom score for clove extract (42.5% vs. 19.0%, p<0.001), tolfenamic acid (84.0% vs. 50.0%, p<0.001), pyritinol (34.1% vs. 16.2%, p<0.01), Hovenia dulcis fruit extract (p=0.029), L-cysteine (p=0.043), red ginseng (21.1% vs. 14.0%, p<0.05) and Korean pear juice (41.5% vs 33.3%, p<0.05). All studied tolerability outcomes were of low or very low quality with no studies reporting any drop-outs due to AEs.
Only very low quality evidence of efficacy is available to recommend any pharmacologically active intervention for the treatment or prevention of alcohol-induced hangover. Of the limited interventions studied, all had favourable tolerability profiles and very low quality evidence suggests clove extract, tolfenamic acid, and pyritinol may most warrant further study.