1-15 HANGOVERS
Not the ethanol—perhaps the methanol
A recent study reported that psychosocial factors such as guilt about drinking, a neurotic personality, becoming angry or depressed while drinking, and having suffered negative life events in the past 12 months are better predictors of hangovers than the amount of alcohol drunk.
Hangover symptoms are worse at a time when almost all ethanol and its metabolite, acetaldehyde, have been cleared from the blood. Peak blood ethanol and acetaldehyde levels are not related to the severity of the hangover. Many drinkers claim not to experience hangover symptoms despite having been intoxicated.
Cogeners—complex organic molecules such as polyphenols and histamine and other alcohols including methanol, which occur in varying amounts in ethanolic drinks, are probably more to blame than ethanol. One study found that hangover symptoms were twice as common in volunteers who drank bourbon whiskey (methanol content 260 mg/L in the brand tested) as in those drinking vodka (0.039 mg/L). The severity of hangover symptoms declined in order—brandy, red wine, rum, whiskey, white wine, gin, vodka, and pure ethanol.
The types of drinks associated with more severe hangovers contain higher levels of methanol. The time course of methanol metabolism corresponds to the onset of symptoms. A small dose of ethanol (which blocks the formation of formaldehyde and formic acid) provides an effective treatment for hangovers (The "Hair of the Dog").
The economic and social consequences of hangover are considerable.
BMJ January 4, 1997; 314: 2-3 Editorial from National Hospital for Neurology and Neurosurgery, London

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