Abstract:The alcohol hangover is defined as the combination of negative mental and physical symptoms, which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero. Here, we present the book “The alcohol hangover: causes, consequences, and treatment”, written to celebrate the 10th anniversary of the Alcohol Hangover Research Group (AHRG), summarizing recent advances in the field of alcohol hangover research.
“…Duolac ProAP4 [14]) may not appeal to individuals who are unable to accurately predict in advance when they are likely to consume excessive alcohol. Concerns are often raised that the pursuit of efficacious hangover remedies may lead people to be more likely to consume excessive amounts of alcohol [30, 31] and ultimately perpetuate development of alcohol‐related harm. No conclusive evidence has validated this concern [8].…”
Section: Discussionmentioning
confidence: 99%
“…This is also the first systematic review in the treatment and prevention of alcohol-induced hangover to use GRADE methodology to assess the quality of the evidence base and the strength of resultant recommen- ProAP4 [14]) may not appeal to individuals who are unable to accurately predict in advance when they are likely to consume excessive alcohol. Concerns are often raised that the pursuit of efficacious hangover remedies may lead people to be more likely to consume excessive amounts of alcohol [30,31] and ultimately perpetuate development of alcohol-related harm. No conclusive evidence has validated this concern [8].…”
Aims: To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover.Methods: 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 1 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 because of adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework.Results: A total of 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 because of AEs.Conclusions: 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.
“…Duolac ProAP4 [14]) may not appeal to individuals who are unable to accurately predict in advance when they are likely to consume excessive alcohol. Concerns are often raised that the pursuit of efficacious hangover remedies may lead people to be more likely to consume excessive amounts of alcohol [30, 31] and ultimately perpetuate development of alcohol‐related harm. No conclusive evidence has validated this concern [8].…”
Section: Discussionmentioning
confidence: 99%
“…This is also the first systematic review in the treatment and prevention of alcohol-induced hangover to use GRADE methodology to assess the quality of the evidence base and the strength of resultant recommen- ProAP4 [14]) may not appeal to individuals who are unable to accurately predict in advance when they are likely to consume excessive alcohol. Concerns are often raised that the pursuit of efficacious hangover remedies may lead people to be more likely to consume excessive amounts of alcohol [30,31] and ultimately perpetuate development of alcohol-related harm. No conclusive evidence has validated this concern [8].…”
Aims: To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover.Methods: 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 1 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 because of adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework.Results: A total of 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 because of AEs.Conclusions: 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.
“…Alcohol hangover is a common consequence of excessive alcohol consumption [2] and is defined as "the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero" [3]. Alcohol hangover is associated with economic, physical, and psychological costs [4] that can exacerbate the impact of other stressful experiences, such as those of the COVID-19 pandemic [5][6][7]. In 2010, the Alcohol Hangover Research Group (AHRG) was founded to promote international research collaboration on alcohol hangover [8].…”
Section: Introductionmentioning
confidence: 99%
“…Joris Verster (Utrecht University, The Netherlands) discussed the progress made by the Alcohol Hangover Research Group over the past 12 years. Most notable were the annual AHRG meetings, the consensus papers on research methodology [9,10], and the establishing of a definition for the hangover [4,11].…”
The determination of ethyl glucuronide (EtG) and ethyl sulfate (EtS) in blood has been proposed in clinical and forensic applications to identify recent alcohol consumption. Also, there is a growing interest on the use of dried blood spots (DBS) in toxicological analysis, allowing increased stability of the analytes, and simplifying sample transportation and storage. This study presents the development and validation of a method for quantifying EtG and EtS in DBS by ultra-performance liquid chromatography–tandem mass spectrometry (UHPLC–MS-MS). The DBS samples were extracted with a mixture of methanol and acetonitrile (80:20 v/v), and analyzed by UHPLC–MS-MS with electrospray source in negative mode, after separation with a fluoro-phenyl stationary phase. Validation was performed according to SWGTOX guidelines, with calibration ranges from 0.10 to 18 µg/mL for EtG and 0.02 to 6 µg/mL for EtS. The analytes were stable in DBS stored from –20 and 45°C for 21 days. The method was successfully applied to capillary and venous DBS samples from 20 volunteers after ethanol ingestion and to DBS samples from 99 fatal victims of road traffic injuries. Capillary DBS was comparable to venous DBS and fresh whole blood in Passing Bablok and Bland Altman analysis, with correlation coefficient > 0.91 (p < 0.001) for all comparisons. In postmortem application, the DBS EtG and EtS analysis indicated positive exposure to ethanol in 72.7% of the cases (EtG: 0.10 to 24.0 µg/mL and EtS: 0.03 to 4.11). The identification of ethanol consumption from blood alcohol concentrations (BAC) and EtG/EtS in DBS was in agreement in 98.6% of positive and 96.3% of negative cases (kappa 0.877, p < 0.001), indicating a high level of concordance with BAC in assessing alcohol use in postmortem samples.
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