Alcohol and migraine: trigger factor, consumption, mechanisms. A review

Abstract

This study investigates the importance of alcohol as a migraine trigger factor, the prevalence of alcohol consumers and the mechanism of headache provocation. A MEDLINE search from 1988 to October 2007 was performed for “headache and alcohol”, “headache and wine”, “migraine and alcohol” and “migraine and wine”. In retrospective studies, about one-third of the migraine patients reported alcohol as a migraine trigger, at least occasionally, but only 10% of the migraine patients reported alcohol as a migraine trigger frequently. Regional differences were reported, perhaps depending in part on alcohol habits. No differences were found between migraine and tension headache and different genders. However, prospective studies limit considerably the importance of alcohol as a trigger. Recent studies show that migraine patients consume less alcohol than controls. Red wine was reported to be the principal trigger of migraine, but other studies show that white wine or other drinks are more involved. Then, the discussion based on the different composition of the various alcoholic beverages, in order to discover the content of alcoholic drinks responsible for migraine attack, reflects this uncertainty. Biogenic amines, sulphites, flavonoid phenols, 5-hydroxytryptamine mechanisms and vasodilating effects are discussed. The fact that few headache patients cannot tolerate some alcoholic drinks does not justify the consideration that alcohol is a major trigger and the suggestion of abstinence. In fact, low doses of alcohol can have a beneficial effect on patients such as migraineurs, who were reported to have an increased risk of cardiovascular disease.

Alcohol use problems in migraine and tension-type headache

“…This finding is con si s tent with previous studies showing lower alcohol consum p tion among patients with migraine when compared to subjects without migraine 7 . This is possibly due to the fact that alcohol may trigger migraine attacks.…”

“…However, to our knowledge, there are not previous studies assessing if there is a reduction of the risk of alcohol use problems in people with migraine compared with the general population 7 . Also, it is still unknown if the risk of alcohol problems is lower among patients with migraine than among patients with tension-type headache.…”

The role of diet and lifestyle in adolescents with headache: a review

“…In addition, dietary habits and single lifestyle factors, as alcohol and caffeine consumption, smoking status, physical activity and body mass index, were found to be associated with headaches in adults [7][8][9].…”

The Relationship Between Frequency, Duration and Intensity of Migraine Attacks and Nutrition

“…3 Alkolün migreni tetiklemesinin altında yatan mekanizmanın etanol, biyojenik aminler (histamine, tiramin, feniletilamin ve diğerleri), sülfitler, fenolik flavonoidler, trombositlerden serotonin salınımı ve dehidratasyon oluşturmasıyla ilişkili olduğu düşünülmekte-dir. 11,35 Norepinefrin salınımı ile tiramin, vasküler endotelden nitrik oksit salınımına neden olan histamin ve trombositlerden serotonin salgılanması ile fenolik flavonoidler gibi kimyasallar çeşitli mekanizmalarla baş ağrısını başlatmaktadırlar. 35 Çalışmalarda migren hastalarının tetikleyici faktör olarak alkolü seçmesi, %17 ve %76 arasında değişiklik göstermektedir.…”

“…11,35 Norepinefrin salınımı ile tiramin, vasküler endotelden nitrik oksit salınımına neden olan histamin ve trombositlerden serotonin salgılanması ile fenolik flavonoidler gibi kimyasallar çeşitli mekanizmalarla baş ağrısını başlatmaktadırlar. 35 Çalışmalarda migren hastalarının tetikleyici faktör olarak alkolü seçmesi, %17 ve %76 arasında değişiklik göstermektedir. 10,11 Milde ve ark.…”