With Christmas over and Dry January in full swing, you might be noticing differences in your migraine attacks if you’ve drunk more or less than normal recently. If there seems to be a connection between alcohol and your migraine, you’re not alone. About a third of people with migraine find that alcohol can trigger their attacks, while about 10 percent find it triggers them on a regular basis, according to a 2016 study.

Alcohol-induced migraine attacks can come on quickly after alcohol consumption, within minutes to hours. Even small amounts of alcohol can trigger an attack. People with migraine are also more likely to experience a headache the morning after drinking. In this blog, we answer some common questions about alcohol and migraine.

Why do I get a migraine attack when I drink alcohol?

Unfortunately, we still don’t know exactly what it is about alcoholic drinks that triggers migraine, and the root cause might be different for different people. For example, it may be the actual alcohol itself that triggers attacks – the chemicals it’s broken down into by the body may directly trigger migraine, or its diuretic effect (an increase in your need to urinate) may lead to a migraine attack by causing dehydration.

Alcoholic drinks also contain certain compounds besides the alcohol itself that may trigger migraine attacks – these are the byproducts of alcohol fermentation. Known as congeners, they are thought by some researchers to trigger headaches – as a general rule, darker drinks tend to have more congeners. This could potentially explain why some people with migraine find they can’t drink certain darker drinks like beer or red wine, however, more research is needed to find out.

Alcohol also causes our blood vessels to expand and increases blood flow, which could contribute to migraine attacks. However, while changes to the blood vessels are involved in migraine, research suggests that they are not the cause of an attack. We now know that migraine is a brain disease, not a disease of the blood vessels as it was once thought to be.

How can I reduce the risk of a migraine attack from drinking?

If alcohol is a trigger for you, it may be best to not drink at all. However, if you find that small amounts of alcohol don’t seem to trigger your attacks, be sure to stick to small amounts when you drink. It could also help to drink water as you’re drinking – dehydration is a very common migraine trigger and alcohol is a diuretic, meaning that it causes your body to remove fluids quicker than usual through your urine.

Sometimes you might get an attack because multiple triggers are working in combination. For example, you might have overslept and skipped breakfast, and be tired and stressed from a busy week at work. Adding alcohol into the mix could then tip you over the threshold for having an attack. If you want to drink, it may be best to do so on days where you feel relaxed, you’ve followed your usual daily routine, and you’ve avoided your other triggers, as this could reduce your risk of a migraine attack.

How can I treat a migraine attack from drinking?

If you feel an attack coming on when you’ve had alcohol, stop drinking straight away. Drink plenty of water and take your usual rescue medication such as triptans or pain relief. These are generally safe to take if you’ve been drinking but don’t drink any more and be aware that the alcohol could make the medication’s side effects worse – for example, you may feel a bit drowsy or dizzy, so lie down and rest if you can. It’s important to always check the leaflet that comes with your medication just in case it says that you should not mix it with alcohol, or ask your doctor about it when they prescribe it.

Can I still drink alcohol if I live with migraine?

There’s no one-size-fits-all answer to this question, as everyone is unique and experiences migraine differently. Many people find that only certain drinks trigger their attacks, so they only need to avoid specific beverages. However, what applies to one person with migraine might be quite different for another.

Keeping a headache diary will help you determine whether alcohol is definitely triggering your attacks. What is and isn’t a trigger can be tricky to untangle; it might be that you tend to drink when you’re very stressed, and it’s actually the stress that’s the trigger, or perhaps you only drink at the weekend and your weekend sleep habits are to blame. Keeping note of things like stress, what you’ve eaten, your caffeine consumption, your menstrual cycle, and your sleep pattern over a few months will help you identify your migraine triggers. You should also record how much alcohol you drink, what types of drink you’ve consumed, and how much. You can take your diary to your doctor and they’ll help you work out what might be triggering your attacks.

Can I drink during a migraine attack?

Although it’s unlikely that you’d feel like it, it’s best not to drink any alcohol while you’re experiencing a migraine attack. Attacks can last for several hours or days after the headache stage eases. This is known as the postdrome stage and can make you feel very fatigued and ‘hungover’. Drinking while you feel like this may make you feel worse and prolong your attack, so it’s best not to drink until you feel completely back to normal.

If you have questions about your migraine or need further information or support, you can contact our free helpline on 0808 802 0066 or email us at info@migrainetrust.org.