Hangover Prevention and Treatment

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Pharmacology of Ethanol[edit]

Target Action Effect Counteracting Agents
GABAA Positive allosteric modulator
  • Relaxation
  • Decrease in anxiety (anxiolysis)
  • Improved mood (euphoria)
  • Impaired judgement
    At higher doses:
  • Memory issues
  • Respiratory depression
  • Unconsciousness
  • Zinc[1]
  • Dihydromyricetin[2][3]
  • NMDA Negative allosteric modulator
    Antagonist (weak)
  • Improved mood (euphoria)
  • Changes in perception
  • Memory issues
  • Decreased cognition
    At higher doses:
  • Confusion
  • Brain damage
  • Hallucination
  • Dissociation
  • Theanine
  • N-acetylcysteine[4][5]
  • Glycine Positive and negative allosteric modulator
    Reuptake inhibitor
  • Caffeine
  • AMPA Negative allosteric modulator*
  • N-acetylcysteine[6]
  • Kainate Negative allosteric modulator*
    α7 Nicotinic-Acetylcholine (nACh) Positive and negative allosteric modulator
    5HT3 Positive allosteric modulator*
  • Nausea
  • Vomiting
  • Ginger
  • Adenosine Reuptake Inhibitor[7]
  • Drowsiness
  • Headache
  • Caffeine
  • 8-chlorotheophylline (in dimenhydrinate)
  • L-type calcium channel Blocker
    GIRK channel Opener*
  • Dependence
  • Reinforcement
  • Naltrexone
  • * Observed only at higher doses.

    Before / during / immediately after drinking[edit]

    • Lots of water is the most effective single way to prevent (or lessen the severity of) a hangover.
    • Ginger: 5HT3 receptor antagonist. Prevents nausea. Directly counteracts 5HT3 potentiation by ethanol. Ginger tea or ginger supplements have the greatest effect, but ginger ale is also effective.
    • Antihistamine antiemetic: diphenhydramine, dimenhydrinate, meclizine. Dimenhydrinate may be optimal due to the 8-chlorotheophyllene.
    • Proton pump inhibitor: omeprazole (Prilosec), lanzoprazole (Prevacid)
    • H2 antagonist: famotidine (Pepsid), ranitidine (Zantac)
    • Vitamin B complex to counter deficiencies that may result from alcohol use
    • Vitamin C in ester form, unless stomach is irritated by ascorbic acid
    • Ibuprofen or naproxen. Naproxen has the advantage of a longer duration of action, but also has a higher (but low) risk of stomach bleeding. Naproxen is preferred unless one has a sensitive stomach.
    • Cannabidiol (CBD) acts as a general analgesic and prevents inflammation. It may also support the immune system.
    • Tetrahydrocannabidiol (THC) (dronabinol) if one is used to its effects. It should be noted that, provided a reliable dosage is possible (high quality extract or a pharmaceutical product like Marinol or Sativex), THC produces beneficial antiemetic effects before it begins to have significant pyschoactive effects. A dose of 2.5 mg to 5 mg is effective in treating nausea in most individuals, while a dose needed to get a "high" usually ranges from 10 mg to 25 mg or higher.
    • Magnesium: may prevent cramping of smooth muscle in the GI tract
    • Dihydromyricetin (ampelopsin) taken after drinking has been shown to reduce the effects of alcohol.[9]

    Morning after drinking[edit]

    • Caffeine, unless stomach is sensitive
    • Bismuth subalicylate (Pepto Bismol™)
    • Glucose/fructose/phosphoric acid (Emetol™)
    • Ibuprofen. Naproxen or aspirin also work, but carry a higher risk of GI irritation
    • Acetaminophen/paracetamol, unless alcohol is still having an effect (never stress liver while drunk)
    • Codeine, unless prone to opioid-induced nausea
    • Repeated from first list:
      • Ginger
      • Antihistamine antiemetics (unless prone to drowsiness)
      • Proton pump inhibitors
      • H2 antagonists
      • Vitamin B
      • Vitamin C ester
      • CBD
      • THC
      • Magnesium
    1. https://www.ncbi.nlm.nih.gov/pubmed/12640458
    2. http://www.jneurosci.org/content/32/1/390
    3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292407/
    4. https://en.wikipedia.org/wiki/Acetylcysteine
    5. https://en.wikipedia.org/wiki/NMDA_receptor#Modulators
    6. https://en.wikipedia.org/wiki/Acetylcysteine#Pharmacology
    7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940831/
    8. https://www.ncbi.nlm.nih.gov/pubmed/19630722
    9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292407/