title: Alcoholic drinks as triggers in primary headaches.
abstract: OBJECTIVE
  This project aims to investigate the role of alcoholic drinks (ADs) as triggers for primary headaches.
  
  
  METHODS
  Patients followed in the Headache Centre and presenting with migraine without aura, migraine with aura (MA), chronic migraine (CM), and tension-type headache (TH) were asked if their headache was precipitated by AD and also about their alcohol habits. Individual characteristics and drink habits were evaluated within two binary logistic models.
  
  
  RESULTS
  About one half (49.7%) of patients were abstainers, 17.6% were habitual consumers, and 32.5% were occasional consumers. Out of 448 patients, only 22 (4.9%), all with migraine, reported AD as a trigger factor. None of 44 patients with MA and none of 47 patients with TH reported AD as a trigger factor. Among those patients with migraine who consume AD, only 8% reported that AD can precipitate their headache. Multivariate analyses showed that AD use, both occasional and habitual, is unrelated to TH. Moreover, analysis performed among migraine patients, points out that occasional and habitual drinkers have a lower risk of presenting with CM than abstainers, although statistical significance occurred only among occasional drinkers. Only 3% of migraine patients who abstain from AD reported that they do not consume alcohol because it triggers their headache.
  
  
  CONCLUSIONS
  Our study shows that AD acts as headache triggers in a small percentage of migraine patients. Differing from some prior studies, our data suggest that AD do not trigger MA and TH attacks. Moreover, the percentage of abstainers in our sample is higher compared with that reported in general population surveys.
authors.affiliation: Headache Centre, Department of Neurology, San Giuseppe Hospital, Empoli, FI, Italy. a.panconesi@virgilio.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Panconesi
authors.forename: Michela
authors.initials: M
authors.lastname: Franchini
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Bartolozzi
authors.forename: Stefania
authors.initials: S
authors.lastname: Mugnai
authors.forename: Leonello
authors.initials: L
authors.lastname: Guidi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects*; D002492:Central Nervous System Depressants / Q000494:pharmacology*; D016001:Confidence Intervals; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology; D020325:Migraine with Aura / Q000150:complications; D015995:Prevalence; D012737:Sex Factors; D013695:Temperance; D018781:Tension-Type Headache / Q000209:etiology; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Alcohol; Alcohol Consumption; Migraine; Tension-Type Headache; Trigger Factors