What Is a Cocktail Headache?

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

Cocktail 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. 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.

Understanding a Cocktail 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.

More specifically, 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 less common than hangover headaches, and they can be triggered by variable amounts of alcohol. In fact, for some people, especially migraineurs, just a small amount of alcohol can lead to this headache.

Alcohol Is a Common Headache Trigger

Alcohol has been reported as a trigger in primary headache disorders, including migraines with or without aura. However, alcohol is not reported as a trigger as much as you would think. For instance, according to a study in The Journal of Headache and Pain, about 30 percent of migraineurs reported alcohol as an occasional trigger while only 10 percent reported alcohol as a migraine trigger frequently.

This could be potentially explained by the fact that migraineurs whose headaches are triggered by alcohol may stop drinking.

Moreover, alcoholic drinks have been noted as a common trigger of cluster headaches, although there is great variability in the scientific research reporting this link. For example, some studies have found that alcohol triggers headaches in about 50 percent of people with cluster headaches whereas other studies have found a much smaller percentage.

Alcohol has also been found to be a potential trigger for tension-type headaches, except the evidence supporting this has is not as robust as that with migraines and cluster headaches.

How Alcohol Triggers Headaches

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 this delayed alcohol-induced headache, experts believe that nerve chemicals involved in central pain control, like serotonin, are likely responsible.

Lastly, in terms of these alcohol-triggered headaches, the type of alcohol does not seem to affect whether a person gets a headache either. For instance, 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.

What Should I Do?

If alcohol is a headache trigger for you, please think before you drink. Ask yourself if it is worth developing a headache over and ruining your celebration or holiday or causing a headache the next day.

That being said, if alcohol only occasionally causes you a headache, then moderation or striking that balance, as opposed to abstinence, may be a more reasonable approach.

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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