TY - JOUR
T1 - The efficacy and tolerability of pharmacologically active interventions for alcohol‐induced hangover symptomatology: A systematic review of the evidence from randomised placebo‐controlled trials
AU - Roberts, Emmert
AU - Smith, Rachel
AU - Hotopf, Matthew
AU - Drummond, Colin
N1 - Funding Information:
This paper represents independent research funded by the Medical Research Council (MRC), as part of the corresponding author's MRC Addiction Research Clinical (MARC) Fellowship. The research was part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King's College London, and by the NIHR Collaboration for Leadership in Applied Health Research and Care South London (NIHR CLAHRC South London) now recommissioned as NIHR Applied Research Collaboration South London, and both C.D. and M.H. received funding from an NIHR Senior Investigator award. The funders had no contribution to the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. All authors were independent from funders had full access to all of the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The views expressed are those of the authors and not necessarily those of the MRC, the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Aims: To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover. Methods: Systematic review of placebo-controlled randomised trials in healthy adults that evaluated any pharmacologically active intervention in the treatment or prevention of hangover. We searched Medline, Embase, PsycINFO and CENTRAL from database inception until 1 August 2021. The primary efficacy outcome was any continuous measure of overall hangover symptoms and the primary tolerability outcome the number of people dropping out because of adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework. Results: A total of 21 studies were included reporting on 386 participants. No two studies reported on the same intervention; as such, meta-analysis could not be undertaken. Methodological concerns and imprecision resulted in all studied efficacy outcomes being rated as very low quality. When compared with placebo, individual studies reported a statistically significant reduction in the mean percentage overall hangover symptom score for clove extract (42.5% vs 19.0%, P < 0.001), tolfenamic acid (84.0% vs 50.0%, P < 0.001), pyritinol (34.1% vs 16.2%, P < 0.01), Hovenia dulcis fruit extract (P = 0.029), L-cysteine (P = 0.043), red ginseng (21.1% vs 14.0%, P < 0.05) and Korean pear juice (41.5% vs 33.3%, P < 0.05). All studied tolerability outcomes were of low or very low quality with no studies reporting any drop-outs because of AEs. Conclusions: Only very low quality evidence of efficacy is available to recommend any pharmacologically active intervention for the treatment or prevention of alcohol-induced hangover. Of the limited interventions studied, all had favourable tolerability profiles and very low quality evidence suggests clove extract, tolfenamic acid and pyritinol may most warrant further study.
AB - Aims: To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover. Methods: Systematic review of placebo-controlled randomised trials in healthy adults that evaluated any pharmacologically active intervention in the treatment or prevention of hangover. We searched Medline, Embase, PsycINFO and CENTRAL from database inception until 1 August 2021. The primary efficacy outcome was any continuous measure of overall hangover symptoms and the primary tolerability outcome the number of people dropping out because of adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework. Results: A total of 21 studies were included reporting on 386 participants. No two studies reported on the same intervention; as such, meta-analysis could not be undertaken. Methodological concerns and imprecision resulted in all studied efficacy outcomes being rated as very low quality. When compared with placebo, individual studies reported a statistically significant reduction in the mean percentage overall hangover symptom score for clove extract (42.5% vs 19.0%, P < 0.001), tolfenamic acid (84.0% vs 50.0%, P < 0.001), pyritinol (34.1% vs 16.2%, P < 0.01), Hovenia dulcis fruit extract (P = 0.029), L-cysteine (P = 0.043), red ginseng (21.1% vs 14.0%, P < 0.05) and Korean pear juice (41.5% vs 33.3%, P < 0.05). All studied tolerability outcomes were of low or very low quality with no studies reporting any drop-outs because of AEs. Conclusions: Only very low quality evidence of efficacy is available to recommend any pharmacologically active intervention for the treatment or prevention of alcohol-induced hangover. Of the limited interventions studied, all had favourable tolerability profiles and very low quality evidence suggests clove extract, tolfenamic acid and pyritinol may most warrant further study.
UR - http://www.scopus.com/inward/record.url?scp=85123480088&partnerID=8YFLogxK
U2 - 10.1111/add.15786
DO - 10.1111/add.15786
M3 - Article
SN - 0965-2140
VL - 117
SP - 2157
EP - 2167
JO - Addiction
JF - Addiction
IS - 8
ER -