MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Are you hungover today? you will be pleased to hear that so-called alternative medicine (SCAM) has a lot to offer – at least this is what its enthusiasts think.

Homeopaths swear by Nux Vomica as the first remedy to think of with hangover headaches, but it is also excellent for headaches from overwork, indigestion headaches and headaches accompanying constipation. Use it when your headache is worse when you cough or bend down, and headaches that aggravate when you move your eyes. If you have overeaten and drunk too much alcohol, you may also feel nauseous and want to vomit to make yourself feel better but find you cannot. If this describes your symptoms then Nux Vomica is the remedy for you.

When I worked as a homeopath, I and others often tried this treatment – it never worked. More importantly, there is not a jot of evidence that it does.

Some people recommend artichoke extract. I say: forget it. Here is why:

BACKGROUND:

Extract of globe artichoke (Cynara scolymus) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms. However, few rigorous clinical trials have assessed the effects of artichoke extract, and none has examined the effects in relation to hangovers. We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover.

METHODS:

We recruited healthy adult volunteers between 18 and 65 years of age to participate in a randomized double-blind crossover trial. Participants received either 3 capsules of commercially available standardized artichoke extract or indistinguishable, inert placebo capsules immediately before and after alcohol exposure. After a 1-week washout period the volunteers received the opposite treatment. Participants predefined the type and amount of alcoholic beverage that would give them a hangover and ate the same meal before commencing alcohol consumption on the 2 study days. The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions. Secondary outcome measures were differences between the interventions in scores using a mood profile questionnaire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure.

RESULTS:

Fifteen volunteers participated in the study. The mean number (and standard deviation) of alcohol units (each unit being 7.9 g, or 10 mL, of ethanol) consumed during treatment with artichoke extract and placebo was 10.7 (3.1) and 10.5 (2.4) respectively, equivalent to 1.2 (0.3) and 1.2 (0.2) g of alcohol per kilogram body weight. The volume of nonalcoholic drink consumed and the duration of sleep were similar during the artichoke extract and placebo interventions. None of the outcome measures differed significantly between interventions. Adverse events were rare and were mild and transient.

INTERPRETATION:

Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover. Larger studies are required to confirm these findings.

Is there anything else you might want to try? I am afraid the answer is NO. Here is our systematic review on the subject:

OBJECTIVE:

To assess the clinical evidence on the effectiveness of any medical intervention for preventing or treating alcohol hangover.

DATA SOURCES:

Systematic searches on Medline, Embase, Amed, Cochrane Central, the National Research Register (UK), and ClincalTrials.gov (USA); hand searches of conference proceedings and bibliographies; contact with experts and manufacturers of commercial preparations. Language of publication was not restricted.

STUDY SELECTION AND DATA EXTRACTION:

All randomised controlled trials of any medical intervention for preventing or treating alcohol hangover were included. Trials were considered if they were placebo controlled or controlled against a comparator intervention. Titles and abstracts of identified articles were read and hard copies were obtained. The selection of studies, data extraction, and validation were done independently by two reviewers. The Jadad score was used to evaluate methodological quality.

RESULTS:

Fifteen potentially relevant trials were identified. Seven publications failed to meet all inclusion criteria. Eight randomised controlled trials assessing eight different interventions were reviewed. The agents tested were propranolol, tropisetron, tolfenamic acid, fructose or glucose, and the dietary supplements Borago officinalis (borage), Cynara scolymus (artichoke), Opuntia ficus-indica (prickly pear), and a yeast based preparation. All studies were double blind. Significant intergroup differences for overall symptom scores and individual symptoms were reported only for tolfenamic acid, gamma linolenic acid from B officinalis, and a yeast based preparation.

CONCLUSION:

No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.

Yes, it’s true, the only sound advice is moderation!

9 Responses to Alternative hangover cures

  • Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial.
    Pittler MH1, White AR, Stevinson C, Ernst E.

    Aha more shameless self-promotion!

    But breaking news from Russia
    A Russian homoeopath has revealed that the best cure for a hangover is to take small doses of sodium thiosulfate, a remedy that is used by members of Russian intelligence agencies. Doctor Mikhail Looschik claims that sodium thiosulfate absorbs alcohol, preventing intoxication. The substance is used to cure alcoholism – long-term use of it makes a person develop an aversion to alcohol.

    Best wishes for the New Year.

    • Sodium thiosulphate used to be used in photographic fixer in the pre-digital era. From much time spent in darkrooms I can tell you that it tastes disgusting.

      It is a chelating agent, which means that it can bind metal ions (such as the silver in photographic emulsion). I would imagine that it might be helpful for heavy metal poisoning, though there are better agents available (e.g. EDTA). I seem to remember reading somewhere that it is effective in acute cyanide poisoning, but I may be mistaken (cyanide is another chelating agent, and used to be used in photography before thiosulphate, though its toxicity is due to a different action as it decouples usable energy generation from burning glucose in cells).

  • I was on a rafting trip on the Kali Gondaki (sp?) river in Nepal in ’95 and we had a party one night. There was an Aussie on the trip who got stumbling drunk, slurring his words, abusing the women and generally obnoxious. The next morning we had to get back in the boats and negotiate the 3 & 4 rated rapids coming up. Needless to say the Aussie was not in good shape; headache, nausea, etc. I gave him a dose of Nux-v 30c (diluted way beyond any substance remaining). He sobered up in about 30 minutes and he got back in the boat without any further hangover symptoms. He finished the trip that day without problem.

    Anyone skeptical of homeopathy with typical hangover symptoms like that, that are characteristic of Nux-v can give it a try.

    • still no clue Roger?

      • Still afraid of your own experience?

        • Still being deceived by your own experience Roger.
          Just like George Washington who believed in blood letting and thought his experience with it was proof of its utility.
          He promoted it to cure whatever ailment in himself as well as his slaves. When he fell ill after a ride in bad weather in 1799, he summoned his doctors, who ardently exsanguiinated him in a vain attempt to cure him.
          Relying on experience can kill.
          Incidentaly, at the time of G. Washington’s death, Hahnemann was developing his ideas of homeopathy and relied solely on experience. Later, the development of scientific approach fixed the problems experience had caused.

          • That’s really relevant. Thanks. There are plenty of studies that show homeopathy works. The SS team just chooses to ignore them in favor of the studies that fit with their beliefs. I cant help that. There is also 200 years of carefully documented clinical practice which is equally valid information that team SS chooses to ignore.

            So all I am asking is that you Super So-called Skeptics (SSS), who can be relied on not to be fooled by placebo, to try it out. I want you to rev up your skepticism to a high pitch, get drunk, and then give it a try. Have a skeptics party and get wasted. This is the time of year for it.

    • an Aussie on the trip who got stumbling drunk, slurring his words, abusing the women and generally obnoxious

      And you decided to ‘help’ this person to get rid of his hangover symptoms? I’m sorry, but you appear to have your priorities backwards … again.
      Someone who starts harassing women when drunk does not deserve help. If there’s one thing people like this need, is to suffer more from their alcohol abuse by way of punishment and (hopefully) deterrent.

      (And oh, of course you’re still a deluded fool. Hangovers clear all by themselves; physical activity can help significantly by speeding up the metabolism and providing mental distraction; homeopathy can only ‘help’ by way of the placebo effect.)

  • @Roger on Sunday 05 January 2020 at 02:13

    There are plenty of studies that show homeopathy works

    You obviously know very little about science and research. It is of little use to read only the severly opined and biased literature produced by those of the homeopathic vocation, people who struggle to defend an empty dream based on a 200 year old failure to understand the perils of relying on experience only.
    There are plenty of studies that are ‘interpreted’ to suggest homeopathy works. All properly performed and analysed studies that have been performed show that homeopathic remedies do not perform better than inert fascimiles of the goods being tested, i.e. placebo. The first such proper study was performed in 1835 and involved the invention of proper scientific trials: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1676327/

    As for your last sentence I suggest you contemplate the famous words of Abraham Lincoln:
    “It is better to keep one’s mouth shut and be thought a fool than to open it and remove all doubt.”

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