Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trialsBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7531.1515 (Published 22 December 2005) Cite this as: BMJ 2005;331:1515
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The authors conclude that "no compelling evidence exists to suggest
that any complementary or conventional intervention is effective for
treating or preventing the alcohol hangover" (1). While this strong
statement might be true with regard to pharmacological interventions, it
seems a bit too sweeping. We must recall that diagnostics, if performed
prudently, can provide useful protection from adverse reactions to drugs
as well as to some food ingredients.
In the context of alcohol intoxication, it is noteworthy that
individuals carrying the inactive ALDH2*2 allele of alcohol dehydrogenase-
2, the enzyme responsible for detoxification of the alcohol metabolite
acetaldehyde, are at higher risk of alcohol intoxication from relatively
low alcohol intake (2-4). Cytochrome p4502E1 (CYP2E1) participates in the
conversion of alcohol to acetaldehyde, and being homozygous for its high-
activity alleles might also be associated with increased susceptibility to
alcohol intoxication (5). NHS-funded pharmacogenetic diagnostics for
identifying alcohol dehydrogenase-2 deficient individuals, combined with
appropriate counseling, could offer a real payback to society by reduced
alcohol-related morbidity and mortality.
1. Pittler MH, Verster JC, Ernst E. Interventions for preventing or
treating alcohol hangover: systematic review of randomised controlled
2. Yoshida A. Differences in the isozymes involved in alcohol
metabolism between caucasians and orientals. Isozymes Curr Top Biol Med
3. Wall TL, Horn SM, Johnson ML, Smith TL, Carr LG. Hangover symptoms
in Asian Americans with variations in the aldehyde dehydrogenase (ALDH2)
gene. J Stud Alcohol. 2000;61:13-17.
4. Yokoyama M, Yokoyama A, Yokoyama T, Funazu K, Hamana G, Kondo S,
Yamashita T, Nakamura H. Hangover susceptibility in relation to aldehyde
dehydrogenase-2 genotype, alcohol flushing, and mean corpuscular volume in
Japanese workers. Alcohol Clin Exp Res. 2005;29:1165-1171.
5. Ishikawa H, Miyatsu Y, Kurihara K, Yokoyama K. Gene-environmental
interactions between alcohol-drinking behavior and ALDH2 and CYP2E1
polymorphisms and their impact on micronuclei frequency in human
Mutat Res. 2005 Aug 25; [Epub ahead of print]
Competing interests: No competing interests
An "Unsystematic" Review of Randomised Controlled Trials Interventions for Preventing Alcohol Hangover
It was disappointing to read the article on hangover prevention that
appeared in the current issue of The British Medical Journal. The
title of the article included the words "Systematic Review of
Randomised TrialsÓ. However after reading the article, it seemed
that the researchers may have been "unsystematic" in their
approach to reporting on one of todayÕs very popular, clinically
proven, hangover prevention "interventions"-- namely that of a
patented extract of derived from the skin of the fruit of the Prickly
Pear, called Tex-OE¨
Why? Because the patented prickly pear extract, lumped in with a
host of truly ineffective hangover prevention interventions, was
found to actually be effective at preventing hangover symptoms in
randomized controlled trials at a major medical university.
Did the research fellows bother to actually read the medical peer
review of the published manuscript of clinical research, performed
by a noted alcohol research team, on the role of the patented
prickly pear extract, Tex-OE¨ in preventing hangover symptoms?
The review was published in the June 28, 2004 issue of the
Archives of Internal Medicine, a publication of the American
Medical Association and it was footnoted in the British Medical
Journal article. So the research fellows must have read it, right?
The clinical study on the patented prickly pear extract was
performed by the distinguished medical research team, that also
published a comprehensive report entitled The Alcohol Hangover,
presented in the Annals of Internal Medicine in July, 2000. It was
performed among 55 graduate medical students at Tulane
In the double-blind, randomized placebo study conducted at
typical-style college barbecue parties on campus at Tulane, the
patented extract, Tex-OE, derived by a special process from the
fruit of the prickly pear cactus, was found to be the first product
ever deemed to be Òstatistically significantÓ at preventing hangover
symptoms when taken before ingesting alcohol. In addition the
study found Tex-OE to provide improved cognitive function the
morning following drinking.
The clinical study reported that the active extract works to prevent
typical hangover symptoms such as dry mouth, fatigue and nausea
by preventing inflammation caused by alcohol. The manufacturer
also has studies that show that the extract has the ability to rapidly
accelerate the synthesis of protective and restorative HSPs (heat
shock proteins in response to various types of stress).
Gerald J. Stefanko has
profited substantially from
new and repeat sales of the
only product clinically
proven to reduce hangover
symptoms in a double blind
placebo study performed by
a noted alcohol research
team at a major medical
Competing interests: No competing interests