An Overview of Cocktail Headache

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

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

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

While many of you are 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 3 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).

Understanding the mechanism through which alcohol can trigger these distinct headache disorders is not well understood. While 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, please think before you drink. In other words, the best 'treatment" for a cocktail headache is actually preventing one in the first place. With that, if you are about to embark on a cocktail delight, ask yourself if it is worth developing a headache over and ruining your celebration or holiday or causing a headache the next day.

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—rest, a tall glass of water, and an over-the-counter painkiller will likely soothe your discomfort.

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

A Word from Verywell

Of course, 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.

Finally, while this article does not focus on alcohol use disorder, if you would like more information please talk with your doctor and consider visiting the website www.niaaa.nih.gov from the National Institute on Alcohol Abuse and Alcoholism.

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