What is the best way to recover from a hangover?

Hangover Recovery: Evidence-Based Approach

Direct Answer

There is no proven effective cure for alcohol hangover, and drinking water does not significantly alleviate hangover symptoms despite popular belief. The most reliable approach is supportive care focused on symptom management while the body metabolizes residual alcohol and recovers naturally.

Why Water Doesn't Work

The widespread belief that dehydration causes hangovers has been definitively challenged by recent research:

• Water consumption during or after drinking has only modest effects on preventing next-day hangover, and the amount of water consumed during hangover is not related to changes in hangover severity 1
• Hangover and dehydration are two co-occurring but independent consequences of alcohol consumption—while hangovers are typically enduring, dehydration effects are usually mild and short-lasting 1
• The positive correlation between water consumption and hangover severity likely reflects that people drink more water when they feel worse, not that water helps 1

Evidence-Based Symptom Management

For Nausea and Vomiting

• Dopamine receptor antagonists (prochlorperazine, haloperidol, metoclopramide) can be used for nausea 2
• For persistent symptoms, consider adding 5-HT3 receptor antagonists or anticholinergic agents 2

For Headache and General Discomfort

• Agents that inhibit prostaglandin synthesis (NSAIDs like ibuprofen or ketorolac) showed positive effects in reducing specific symptoms 3
• These reduce headache but are not effective for drowsiness and fatigue 3

Nutritional Support

• Electrolyte-rich fluids (sports drinks) or nutrient drinks should be consumed during the recovery phase 4
• Vitamin supplementation, particularly B-complex vitamins (thiamine, B12, folic acid, pyridoxine) is important, especially for regular alcohol users 2
• Thiamine can be administered orally or enterally at 100-300 mg/day 2

What Limited Evidence Exists for Prevention

A systematic review identified only a few interventions with any evidence:

• Polysaccharide-rich extracts, red ginseng, and Korean pear juice showed some improvement in specific symptoms (tiredness, nausea, stomachache) but were not effective for all symptoms 5
• Agents that accelerate alcohol metabolism showed some positive effects 3
• None of these methods were effective for all hangover symptoms 5

The Reality Check

Most remedies do not significantly reduce overall hangover severity 3. The pathology of alcohol hangover remains poorly understood, and until this is elucidated, it is unlikely that an effective hangover cure will be developed 3. The hangover develops as blood alcohol concentration approaches zero and is characterized by a general feeling of misery that resolves with time 6, 7.

Critical Pitfall to Avoid

Do not rely on "morning after" drinking (the "eye-opener") to relieve hangover symptoms—this is actually a screening question for alcohol dependence 4 and perpetuates the cycle of alcohol use.

Bottom Line Algorithm

1. Symptomatic relief: NSAIDs for headache, antiemetics for nausea 2, 3
2. Nutritional support: Electrolyte-rich drinks and B-vitamin supplementation 4, 2
3. Rest and time: Allow the body to metabolize alcohol naturally 3
4. Prevention focus: The only reliable prevention is drinking less alcohol or abstaining entirely 1, 3