How to Manage Your Alcohol Consumption to Prevent Migraine Attacks

Understanding whether alcohol is a migraine trigger and how to treat and prevent it can help you make the best choices about what and how much you drink.

A glass of wine with dinner. A beer while watching the game. Bubbly at a wedding.

Alcohol is often just a part of social gatherings, though consuming too much can have short-term and long-term consequences.

On top of that, alcohol is a possible migraine trigger. Limiting or eliminating alcohol may help prevent migraine, but does that mean no booze — ever?

Here’s what to know about preventing migraine attacks when also drinking alcohol, plus how to treat one if it’s too late.

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Does alcohol cause migraine?

The role of alcohol in triggering migraine attacks is unclear, and the research is limited.

“Alcohol may have different effects on different people,” said neurologist Noah Rosen, MD. “We are not all built the same.”

Rosen was a co-author of a small 2022 study of 487 people who mostly drank alcohol in low amounts. The data did not suggest a significant link between consuming alcohol and a migraine attack within 24 hours.

However, alcohol is traditionally considered a migraine trigger, with some research suggesting that it prompts episodes in about one-third of people. Rosen said some people he treats report being triggered by simply smelling alcohol.

Yet, a 2016 study pointed out that estimates vary and the reason that alcohol use might trigger migraine episodes is still unclear.

Some theories include:

• sensitivity to the smell
• sensitivity to the taste
• disrupted sleep
• dehydration from drinking alcohol
• breakdown of aldehyde, a compound produced when the body processes alcohol
• histamine release

Primary care physician Monica Kalra, DO, explained that alcohol can cause histamine release, and histamine can cause the widening of blood cells in the brain, which may trigger a migraine attack.

Just like no two people are alike, different types of alcohol have distinct chemical makeup and effects on the body.

Pain medicine specialist Thomas Pontinen, MD, LCP-C, notes that darker beverages like red wine can have more potentially triggering ingredients than lighter-colored beverages. These include:

• sugar
• sulfates
• tannins
• histamine

“These different chemicals could all potentially contribute to migraine in individuals, but those biomechanical links are not yet well defined,” Pontinen said. “Everybody is different, and each person responds differently to different chemicals.”

Does alcohol relieve migraine?

But what about the idea that alcohol might soothe or even reduce migraine episodes?

A 2023 review indicated that the risk of migraine in people who drink alcohol is about 1.5 times lower than in those who don’t, though the studies reviewed had a high amount of bias.

However, that doesn’t mean alcohol reduces migraine attacks. The authors noted that a likely explanation for their findings is that people with migraine may avoid drinking alcohol, while those who don’t experience migraine partake with less hesitation.

“Someone may feel a slight relief from a migraine [attack] after drinking due to the sedative effects alcohol has, but this is only for a short amount of time and will not last,” said neuropsychologist Sanam Hafeez, PhD.

Pontinen agrees.

“Red wine is largely believed to be a common cause of migraine and has not been observed clinically to help with it,” Pontinen said. “That said, some people have reported experiencing relief from a bit of red wine, likely due to the resveratrol it contains.”

Resveratrol is a plant compound that may have some health benefits, like lowering blood pressure, though more research is needed.

Migraine vs. alcohol-induced headache

Different than a migraine episode, an alcohol-induced headache is precisely what the name implies: A headache caused by consuming alcohol.

These headaches can be immediate or delayed. A delayed alcohol-induced headache is what we commonly call a hangover.

“A migraine is a neurological health condition that generally involves an intense sensation of throbbing pain, strong sensitivity to lights and sounds, and feelings of sickness like nausea and vomiting,” Pontinen said. “The causes of migraine are still poorly understood, but we know there’s usually an interplay between brain activity, blood flow, inflammation, and neurotransmitters such as serotonin.”

Migraine episodes triggered by alcohol consumption typically happen within about an hour. Delayed alcohol headaches or hangovers generally take hours to start, such as the following day after a night of drinking too much.

“Hangovers only occur in the context of binge and withdrawal of alcohol,” Rosen said. “People with migraine are susceptible to other types of headaches, like tension headaches or icepick headaches, so it is possible to have two conditions.”

Additionally, it’s possible to have migraine episodes and hangovers, Rosen said.

An older 2014 study compared 95 people with migraine with 597 people without migraine. The results indicated people with migraine had higher chances of having hangover symptoms similar to those they experienced during episodes. 

How to tell if alcohol triggers your migraine attacks

Since the research on alcohol as a migraine trigger is limited, and everyone’s body metabolizes foods and drinks differently, it can be helpful to tune into what yours is telling you.

“I’d recommend keeping a detailed journal as much as possible to try and find patterns in what might actually be triggering your [attacks],” Pontinen said. “Take notes every time you drink alcohol, even if you don’t have [an attack].”

Pontinen suggests recording:

• date and time
• quality of alcohol
• type of alcohol
• sleep quality
• foods eaten
• hydration levels
• medications or drugs consumed in the 24 hours before the episode

“After a few months or a good handful of episodes, you can go back through the journal, put a red circle around any occasions that correlated with migraine, and make the appropriate changes that’ll hopefully [prevent] the issue from happening again,” Pontinen said.

How to treat alcohol-induced migraine

Understanding ways to treat an alcohol-induced migraine attack already in progress and prevent one altogether can be empowering. Here are some tips for both.

Tips for management when the attack is already happening

If you consumed alcohol and are now in the midst of a migraine attack:

• Drink fluids with electrolytes, like water with a pinch of salt and fresh-squeezed lemon, to lessen symptoms caused by dehydration.
• Take NSAIDs like ibuprofen to reduce inflammation and pain signals, in appropriate amounts discussed with your doctor.
• Rest.
• Take migraine medications as applicable as soon as symptoms start.
• Use cold compresses, ice packs, or cold caps fresh out of the freezer.
• Remove yourself from environments with bright lights and loud noises.

Tips for prevention

To prevent an alcohol-induced migraine attack:

• Remain hydrated.
• Avoid certain types of alcohol that may trigger you.
• Limit alcohol consumption overall.
• Eat while drinking to slow the body’s absorption of alcohol.
• Spread out drinks over a few hours.
• Get plenty of sleep before and after drinking.
• Eat nourishing foods and “pre-hydrate” 24 to 48 hours before consuming alcohol.

The type of alcohol that contributes to migraine varies by the person, which is why journaling can be helpful.

“For some, avoiding red wine or dark liquor is enough,” Pontinen said. “For others, it’ll involve limiting a lot more. Limiting alcohol consumption is also a great idea in general for many health reasons, but if you’re a chronic [migraineur] who has decided to have a drink or two, a safe bet is leaving it at that.”

What about triptans?

Pontinen said triptans are commonly used to treat migraine once symptoms start. Taking one before drinking isn’t recommended or known to be effective.

“You may benefit from taking the medication once mild migraine symptoms start to set in, even after you’ve been drinking, because it can potentially reduce the … episode’s intensity and duration,” Pontinen said. “However, if you start to feel symptoms of a migraine [attack], it’s best to stop consuming alcohol, even if you have taken your medication.”

He also recommends speaking with a doctor before mixing triptans with alcohol or other drugs.

“Triptans typically don’t interact with alcohol, but your doctor is the only person who can make that confirmation for you,” he said.

Frequently asked questions

Read on for answers to common questions about alcohol and migraine.

Can alcohol help a migraine?

Alcohol may temporarily offer sedation but isn’t proven to be effective at soothing or preventing migraine. Alcohol is considered a potential migraine trigger, though research isn’t clear on why.

What is the best drink for a migraine?

Remaining hydrated is one way to reduce migraine attacks, but the type of beverage you choose matters. Nonalcoholic beverages with little to no added sugar are the best drinks for migraine. These include water, electrolyte drinks, bone broth, and diluted fruit juices.

Why does wine help migraine?

It’s unlikely that wine helps with migraine. Any relief experienced from red wine likely comes from resveratrol, a potentially health-boosting plant compound.

What not to drink during a migraine attack?

Avoid alcoholic and sugary drinks when you have migraine, especially during an attack. Dark liquors and red wines may be particularly harmful due to their sugar, sulfate, tannin, and histamine content.

Takeaway

Alcohol may trigger migraine attacks, and it’s very unlikely to ease them. Alcohol-induced migraine is different than a hangover, which is caused by overconsuming alcohol.

It’s unclear why alcohol may trigger migraine, but red wine and liquor may be more likely to do so because of the chemical compounds they contain.

Keeping a migraine journal that includes the type of alcohol consumed, time, and any other potential triggers can help you determine whether it’s in your best interest to avoid alcohol.