Intended for healthcare professionals

Student Education


BMJ 2002; 324 doi: (Published 01 June 2002) Cite this as: BMJ 2002;324:0206184
  1. David Lucey, fifth year medical student1
  1. 1University College Dublin

Why do they happen and what is the best cure? David Lucey indulges, for your education of course

Your eyes open slowly, and you realise you're wearing someone else's underpants over your trousers. It's half an hour after the start of the microbiology tutorial you promised yourself you would go to, after you missed it the week before. You feel like something angry has ravished your head and died in your mouth. You don't congratulate yourself on the self-diagnosis of a hangover, also known as veisalgia (from the Norwegian “kveis”, meaning “uneasiness following debauchery,” and the Greek “algos,” meaning “pain”).

What causes this to happen? What occurs between the time you are swigging triple whiskeys and chatting up a barstool, and the following barrage of mini-explosions in your head?

Surprisingly, ethanol itself may only be a minor player in generating the nausea, sweating, tremor, thirst, headache, fatigue, remorse, and anxiety that hangover sufferers report. The fact that symptoms are at maximum severity when virtually all of the ethanol and its metabolite acetaldehyde have been cleared from the bloodstream is evidence for this. In addition, peak blood concentrations of ethanol or acetaldehyde do not correlate with the …

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