Alcohol and Migraine

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Key Questions
  • Is alcohol a proven trigger for migraine?
  • Why should we specify a brand when ordering an alcoholic drink?
  • How are histamines in alcohol a migraine trigger?
  • Would taking an antihistamine prevent an alcohol-related migraine?
  • How does alcohol impact sleep?
  • How is sleep apnea related to migraine?
  • What are some strategies for preventing alcohol-related headaches and migraine attacks?
  • What are some chemical compounds in alcohol that could trigger migraine?
  • How should we choose an alcoholic spirit when looking at a bar or restaurant menu?
  • What are some considerations when trying to choose wine that will not trigger a migraine attack?
  • Is organic wine better for avoiding a migraine attack?
  • Are clear spirits like vodka better than darker ones for avoiding a migraine attack?
  • Are mixed drinks advisable when trying to avoid migraine?
  • Is beer better than wine when trying to avoid an alcohol-related migraine attack?
  • What are the toxic effects of alcohol?
  • Why should we avoid taking acetaminophen when we have been drinking?
  • How can we test different alcoholic drinks to determine whether they trigger migraine attacks for us?
  • Is it necessary to stop drinking altogether if we want to avoid migraine attacks?
  • What is the best way to treat an alcohol-induced migraine attack?
Interview Notes
Treatments Mentioned
  • Acetaminophen
  • Antihistamines
  • Benadryl 
  • Cyproheptadine 
  • NSAIDs
  • Triptans

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.


Assistant Professor of Neurology
Harvard Medical School

Paul G. Mathew, MD, DNBPAS, FAAN, FAHS, completed his neurology residency at Temple University Hospital in Philadelphia, PA, and held a fellowship in headache medicine at Mayo Clinic in Rochester, MN. He is board certified in neurology and headache medicine. He is currently an assistant professor of neurology at Harvard Medical School (HMS), and an affiliate member of the HMS Division of Sleep Medicine. He holds positions at three HMS-affiliated institutions. He has clinical appointments at Mass General Brigham and Harvard Vanguard Medical Associates/Atrius Health, as well as a teaching appointment at the Cambridge Health Alliance. As part of his headache and sports neurology/concussion practice, Dr. Mathew performs Botox injections, nerve blocks, and trigger point injections.

He has written over 90 publications, and has presented at both national and international conferences. He is the co-chief medical editor of the journal Practical Neurology. He is an active member of several medical societies, including the American Academy of Neurology, the Massachusetts Neurological Association, the American Headache Society, the International Headache Society, the American College of Sports Medicine, the American Association of Physicians of Indian Origin, and the Indian Medical Association of New England.

Dr. Mathew applies his passion and expertise to the role of advocate for both patients and fellow physicians, and has participated in multiple successful lobbying efforts in Washington, D.C.

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