Cocktail Headaches

This type of headache is much less common than a hangover headache

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Sipping a fizzing glass of champagne or a soothing glass of red wine during the holidays can be a pleasurable experience. But sometimes, alcohol ingestion can induce a headache, within as little as three hours after consumption.

Let's take a closer look at what exactly is a cocktail headache, more formally known as an immediate alcohol-induced headache.

While you may be familiar with that dreaded, uncomfortable hangover headache after an evening of drinking one or more alcoholic beverages, a cocktail headache occurs that same evening and does not typically correlate with the quantity of alcohol consumption.

Symptoms

According to the International Headache Society, a cocktail headache occurs within three hours after a person consumes an alcoholic beverage and resolves within 72 hours. It also includes at least one of the following three features:

  • The headache occurs on both sides of the head
  • The headache is throbbing or pulsating (imagine your brain as a drum)
  • The headache is aggravated by physical activity

It's interesting to note that cocktail headaches are much rarer than hangover headaches, and they can be triggered by variable amounts of alcohol. For instance, for some migraineurs, just a small amount of alcohol can lead to a cocktail headache, whereas other migraineurs can tolerate alcohol at the same level as non-migraineurs.

Cause

Besides a cocktail or hangover headache, alcohol has also been reported as a trigger in primary headache disorders, most notably migraine and cluster headaches, followed by tension headaches (although the evidence is not as robust).

The mechanism through which alcohol can trigger these distinct headache disorders is not well understood. While the acute widening of blood vessels in the brain (called vasodilation) may explain the cocktail headache, this is likely not the mechanism for hangover headaches (when alcohol levels in the blood have declined to zero).

For a hangover headache, also called a delayed alcohol-induced headache, experts believe that nerve chemicals involved in central pain control, like serotonin, are likely responsible.

The type of alcohol does not seem to affect whether a person gets a headache. While red wine has been described as a dominant trigger of migraines and cluster headaches, white wine, champagne, sparkling wines, and beer have also been linked to headaches.

Treatment

If alcohol is a headache trigger for you, think before you drink. In other words, the best treatment for a cocktail headache is actually preventing one in the first place. Before consuming a cocktail, ask yourself if it is worth developing a headache over and ruining your celebration or holiday.

If alcohol only occasionally causes you a headache, then moderation or striking that balance (as opposed to abstinence), may be a more reasonable approach.

If you do develop an occasional cocktail headache, soothe your discomfort with rest, a tall glass of water, and an over-the-counter painkiller.

Be sure to talk with your doctor about your "cocktail headache" plan. For example, if you suffer from migraines and notice that alcohol triggers your migraine headache then taking one of your migraine therapies (for example, a triptan) at the start of your headache may be best.

Headaches Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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A Word From Verywell

If you and/or others are concerned about your alcohol intake, please seek the guidance of your healthcare provider, as alcohol intake can have serious health and social consequences. If you would like more information on alcohol use disorder, talk with your doctor or contact the National Institute on Alcohol Abuse and Alcoholism.

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Article Sources

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  1. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808. doi:10.1177/0333102413485658

  2. Panconesi A, Bartolozzi ML, Mugnai S, Guidi L. Alcohol as a dietary trigger of primary headaches: what triggering site could be compatible?. Neurol Sci. 2012;33 Suppl 1:S203-5. doi:10.1007/s10072-012-1068-z

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