If you browse the internet you can find dozens of products purporting to prevent hangovers. Do any of these hangover prevention products actually work? Dr. Max Pittler, MD, PhD asked himself this question and did an exhaustive search of the scientific literature looking for its answer. What he found were three hangover preventatives which showed significantly better results than a placebo in randomized, double blind studies. Another five hangover preventatives failed to perform better than placebo. But the vast majority of hangover prevention products have not yet been tested in randomized, placebo controlled, double blind studies--so it is anyone's guess whether they are really effective or not. A couple of these have shown some promise, but further trials are needed to verify their effectiveness.
The three items which Dr. Pittler found effective for hangover prevention are borage seed oil, tolfenamic acid, and a yeast preparation. The five items which did not work are artichoke extract (also called Cynara scolymus), prickly pear cactus extract (also called O ficus-indica), tropisetron (a serotonin receptor antagonist), propranolol (a beta blocker), and fructose (a sugar).
The Three That Worked
Borage seed oil - In an unpublished research report Moesgaard and Hansen tell us how a commercial preparation of borage seed oil sold under the name Bio-glandin 25 was tested as a method for preventing hangover. Test subjects consumed 8 or 9 standard US drinks (140 to 160 ml pure ethanol) in a party setting. Subjects were given 8 capsules of Bio-glandin 25 before consuming any alcohol. Subjects were given a questionnaire which they completed and returned the following day. Subjects taking the Bio-glandin 25 reported significantly less hangover than those receiving the placebo (p < 0.01). Borage seed oil is sold in the US as a dietary supplement.
Tolfenamic acid - Tolfenamic acid is not approved for sale in the US for either humans or for veterinary purposes. It is approved for use as a pain killer in cats and dogs in Canada. In 1983 Dr. Kaivola and colleagues tested tolfenamic acid as a method for hangover prevention in Finland. Subjects were given 200 mg of tolfenamic acid before they started drinking and another 200 mg immediately after finishing. Exact amounts of alcohol consumed were not reported. Hangover symptoms were evaluated the following day with subjects who took tolfenamic acid reporting significantly fewer symptoms than those who received a placebo (p < 0.01).
The Yeast Preparation - In 1999 Dr, Laas evaluated the efficacy of a called Morning Fit which is apparently no longer being manufactured. Morning Fit consisted of 250 mg dried yeast, 0.5 mg thiamine nitrate, 0.5 mg pyridozine hydrochloride and 0.5 mg riboflavin. Test subjects were given 3 tablets of Morning Fit after a 3 hour drinking session where 7 US standard drinks (ethanol 100 g) were consumed in the form of 80 proof vodka. Eight hours later a hangover questionnaire was administered. Subjects receiving Morning Fit reported significantly fewer hangover symptoms than those receiving a placebo (p < 0.05).
Dr. Pittler notes that none of the above preventatives completely eliminated hangovers, but that they did lessen the symptoms.
Avenues for Further Research
Dr. Pittler notes that there seems to be some evidence that a Traditional Indian Ayurvedic Preparation called Liv52 might be effective for hangover prevention. Additional research in the form of placebo controlled double blind trials is needed to confirm this. Dr. Pittler also notes that there is reason to do further research on pyritinol and prickly pear (O ficus-indica) extract. And succinic acid--the primary ingredient in the popular hangover cure RU21 has yet to be evaluated in a scientific study.
Should Hangovers Be Cured?
Some researchers have raised an ethical question--do hangovers work as a deterrent to heavy drinking? Would curing hangovers lead to an increase in heavy drinking? Although we cannot answer this with certainty, there is another way to view this question. People are known to take a hair of the dog to cure their hangovers. People without hangovers have no need for a hair of the dog. So this leads us to ask the converse question--could curing hangovers lead to a reduction in heavy drinking?
Chauhan BL, Kulkarni RD. (1991). Alcohol hangover and Liv.52. European Journal of Clinical Pharmacolology. 40: 187-8
Kaivola S, Parantainen J, Osterman T, Timonen H. (1983). Hangover headache and prostaglandins: prophylactic treatment with tolfenamic acid. Cephalalgia. Mar;3(1):31-6.
Laas I. (1999). A double-blind placebo-controlled study on the effects of Morning Fit on hangover symptoms after a high level of alcohol consumption in healthy volunteers. Journal of Clinical Research. 2: 9-15.
Pittler MH. (2004). Complementary therapies for alcohol hangovers. Focus on Alternative and Complementary Therapies. 9: 265-8
Pittler MH, Verster JC, Ernst E. (2005). Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials. BMJ. 2005;331;1515-1518