REVIEW OF: Jayawardena R et al, Hum Psychopharmacol 2017;32(3). Epub 2017 Jun 1.

As clinicians, we’re more interested in preventing excessive drinking than curing hangovers. But it’s always nice to have some helpful advice for patients, which we found in a recently published literature review of clinical trials of hangover treatments.

The authors used keywords to search for all relevant English-language studies occurring between January 1, 2009 and June 30, 2016. This search yielded 6 controlled studies of 5 potentially effective herbal products were identified, 3 with a placebo control. All participants in these final 6 studies were healthy adults between ages 19 and 58. Five of the studies had 9–28 subjects, with one study having 103. Four of the studies had only men included; the others included both men and women.

No published studies found any treatments to be clearly effective. One study of dandelion juice suggested efficacy but did not have sufficient statistical power. The following interventions were associated with a significant statistical improvement in hangover severity (p < 0.05): the polysaccharide-rich extract Acanthopanax senticosus; red ginseng anti-hangover drink; Korean pear juice; KSS formula (Kitsuraku, Shokyo, brown sugar, and dextrin); and After-Effect©. The highest improvements were observed for the following symptoms: tiredness, nausea, vomiting, and stomachache. The lowest improvements were found for palpitations and other cardiovascular symptoms.

After-Effect© is a mixture of borage oil (gamma linolenic acid); fish oil (omega-3); vitamins B1, B6, and C; magnesium; ­Silybum marianum (silymarin); and Opuntia ficus-indica. For the 103 subjects using After-Effect© before and after a night of heavy drinking, and then alternatively not using the supplement on a night of heavy drinking, their mean Acute Hangover Scale scores were 2.33 (SD 1.6) with the supplement versus 5.18 (SD 1.9) without it. (A mean Acute Hangover Scale score of 10 represents extreme symptoms, while 0 is absence of hangover symptoms.) This study showed the most significant improvement in hangover severity, with p < 0.01.

CATR’s Take
The best hangover prevention is obviously to avoid alcohol entirely, or at least to drink in moderation. But our patients will get hangovers, so it behooves us as psychiatrists and substance abuse specialists to be familiar with falsifiable hangover treatments. Current available evidence shows several products that may potentially improve hangover symptoms, but more research is needed. ­Acanthopanax senticosus, red ginseng, and Korean pear juice are easily available via amazon.com; KSS formula is a traditional folk remedy in China; and After-Effect©, developed by the company Deenox, can be found in French pharmacies. This is clearly useful information to share with our patients.