Oral Minoxidil and Alcohol Hangover: Is There a Connection?

In recent years, low-dose oral minoxidil has become an increasingly popular treatment option for various types of alopecia (hair loss). While the topical form of the medication has been used for decades, the oral version has gained traction due to its practicality and effectiveness. However, like any medication, it is important to be aware of its possible side effects and interactions. A recently observed interaction deserves special attention: the potential intensification of alcohol hangover symptoms.

What is low-dose oral minoxidil?

Minoxidil was originally developed as a medication for hypertension, typically used in doses of 10 to 40 mg daily for this purpose. Its most well-known side effect, hair growth, led to the development of the topical version for alopecia treatment.

Currently, low-dose oral minoxidil (0.25–5 mg daily) is used "off-label" (usage not approved in the official label) for various types of hair loss, such as androgenetic alopecia (male or female pattern baldness), telogen effluvium, alopecia areata, and even some scarring alopecias.

A multicenter study published in 2021 with 1,404 patients showed that low-dose oral minoxidil has a good safety profile.³ The most common side effects include hypertrichosis (excessive hair growth in unwanted areas), dizziness, fluid retention, tachycardia, headache, and periorbital edema.

The possible relationship with alcohol hangover

A recent comment published in the International Journal of Dermatology by Alhanshali et al. (2024) brought attention to a possible interaction between oral minoxidil and alcohol that had not been widely documented: exacerbation of hangover symptoms.

The authors reported that after prescribing low-dose oral minoxidil to hundreds of patients, they observed about 10 cases in which patients reported a significant worsening of hangover symptoms after alcohol consumption, including:

• More intense headaches
• Increased nausea
• Greater light sensitivity

How does this interaction occur?

The exact mechanisms of this interaction are not yet fully understood, but some hypotheses are proposed:

• Additive vascular effects: Both minoxidil and alcohol cause vasodilation, which could potentially influence alcohol absorption and/or metabolism, intensifying its effects.
• Overlap of side effects: Some minoxidil side effects, such as headache and dizziness, are also common hangover symptoms, possibly resulting in an additive effect.
• Enzymatic alterations: A study cited by the authors demonstrated that ethanol can increase the activity of phenol sulfotransferase (SULT1A1) in the intestine, an enzyme crucial for the bioactivation of minoxidil. This enzymatic interaction could theoretically modify the metabolism of both substances.

Alcohol hangover: understanding the phenomenon

To better understand this interaction, it is important to define what an alcohol hangover is. "Veisalgia" (the medical term for hangover) is defined as "a combination of negative physical and mental symptoms that can be experienced after a single episode of alcohol consumption, beginning when blood alcohol concentration approaches zero."

Main symptoms include:

• Fatigue
• Headache
• Increased thirst and dry mouth
• Nausea and vomiting
• Dizziness
• Sensitivity to light and sound
• Tremors
• Excessive sweating
• Tachycardia (rapid heartbeat)
• Anxiety and irritability

The mechanisms causing hangover are multifactorial and include:

• Dehydration and electrolyte imbalance
• Gastrointestinal disturbances
• Low blood sugar
• Alterations in sleep and biological rhythms
• Inflammation
• Effects of components other than ethanol present in beverages (congeners)
• Alcohol metabolites, especially acetaldehyde

Recommendations for patients using oral minoxidil

Based on these observations, the authors make several recommendations for patients using low-dose oral minoxidil:

• Avoid taking minoxidil on days of heavy alcohol consumption: In clinical practice, doctors have advised patients not to take their minoxidil dose on days they plan to drink large amounts of alcohol.
• Monitor individual response: Since this interaction seems to affect only a small percentage of patients, it is important that each person observes how their body reacts to the combination of minoxidil and alcohol.
• Inform your doctor: If you use oral minoxidil and notice intensified hangover symptoms after alcohol consumption, inform your dermatologist for proper guidance.

Final considerations

It is important to emphasize that the interaction between oral minoxidil and alcohol still requires further studies to precisely establish its prevalence, mechanisms, and mitigation strategies. Most patients using low-dose oral minoxidil likely will not experience this interaction, but being aware of the possibility allows for safer medication use.

As with any medication, oral minoxidil should only be used under medical prescription and supervision. If you are considering starting this treatment for hair loss, discuss all possible interactions and side effects with your dermatologist to make an informed choice.

It is also worth remembering that responsible alcohol consumption is always recommended, regardless of medication use. Staying hydrated, not drinking on an empty stomach, and respecting your body’s limits are fundamental practices to reduce risks associated with alcohol consumption.

References:

1. Alhanshali L, Desai D, Nohria A, Shapiro J, Lo Sicco K. Oral minoxidil and the exacerbation of alcohol hangover symptoms. Int J Dermatol. 2024;63(7):975-976. doi: 10.1111/ijd.17195
   2. Swift R, Davidson D. Alcohol hangover: mechanisms and mediators. Alcohol Health Res World. 1998;22(1):54-60.
   3. Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, Moreno-Arrones OM, Saceda-Corralo D, Rodrigues-Barata R, et al. Safety of low-dose oral minoxidil for hair loss: a multicenter study of 1404 patients. J Am Acad Dermatol. 2021;84(6):1644-51. doi: 10.1016/j.jaad.2021.02.054
   4. Maiti S, Chen G. Ethanol up-regulates phenol sulfotransferase (SULT1A1) and hydroxysteroid sulfotransferase (SULT2A1) in rat liver and intestine. Arch Physiol Biochem. 2015;121(2):68-74. doi: 10.3109/13813455.2014.992440
   5. Verster JC, Scholey A, van de Loo AJAE, Benson S, Stock AK. Updating the definition of the alcohol hangover. J Clin Med. 2020;9(3):823. doi: 10.3390/jcm9030823
   6. Minoxidil and alcohol/food interactions [Internet]. Drugs.com; [cited 2025 May 14].

Estrogen and Alcohol: Can Hormones Influence Alcohol Consumption in Women?

Research suggests that estrogen may influence excessive alcohol consumption among women. A study published in Nature Communications shows how this hormone affects brain pathways in female mice related to motivation and stress, pointing to a possible biological mechanism that could increase female vulnerability to alcohol.

Excessive alcohol consumption among women has been increasing in recent years. And although abusive alcohol use causes serious health damage to anyone, alcohol impacts women’s health significantly due to biological and physiological differences compared to men.

Some studies have mentioned that hormonal factors, such as estrogen, can drive alcohol-related behaviors.¹–³ Based on this, a study published in Nature Communications⁴ investigated how estrogen might regulate alcohol consumption behavior in female mice and which brain and molecular pathways are involved in this process.

To investigate the role of estrogen in excessive alcohol consumption in females, researchers observed alcohol intake throughout the estrous cycle (similar to the menstrual cycle in humans) and applied the Drinking in the Dark (DID) protocol, which simulates binge drinking episodes. Additionally, they performed hormonal manipulations by administering estrogen and selective blockers of membrane-associated estrogen receptor alpha (ERα), responsible for rapid, non-genomic hormonal action. Finally, they used electrophysiological techniques to assess the activity of CRF neurons (corticotropin-releasing factor – a peptide involved in the stress response) in the bed nucleus of the stria terminalis (BNST), aiming to identify how this hormonal pathway influences neuronal excitation and alcohol-seeking behavior.

The study results demonstrated that estrogen exerts a direct and significant influence on excessive alcohol consumption behavior in female mice. It was observed that during the phases of the estrous cycle when estrogen levels were highest, females showed a marked increase in ethanol intake, suggesting a relationship between hormonal peaks and vulnerability to compulsive consumption. When estrogen was administered exogenously, consumption also increased, confirming this association. Conversely, blocking ERα estrogen receptors reduced this behavior. Moreover, estrogen increased the activity of CRF neurons in the BNST, a brain region linked to stress and motivation, indicating that this hormonal pathway directly contributes to alcohol-seeking behavior.

Can We Apply These Findings to Women?

Although the findings of this study in mice offer important clues about how estrogen may influence excessive alcohol consumption in females, caution is needed when applying these conclusions directly to women.

Animal models are essential for understanding biological mechanisms but do not reflect the full complexity of human experiences, which involve social, emotional, and cultural factors, especially regarding alcohol use. Additionally, the study analyzed only the acute effects of estrogen in a specific brain region, leaving open how this hormone may act in contexts of chronic use or in association with other human variables.

Still, the results suggest a possible biological mechanism that may help explain women’s greater vulnerability to the harmful effects of alcohol. Therefore, these findings reinforce the need for further research with women that investigates the role of sex hormones in motivation for alcohol consumption, aiding the development of more effective and gender-sensitive prevention and treatment strategies.

References:

1. Johnson CS, Mermelstein PG. The interaction of membrane estradiol receptors and metabotropic glutamate receptors in adaptive and maladaptive estradiol-mediated motivated behaviors in females. 2022 Jan 1;33–91.
2. Torres VC, Feng B, Yang X, Patel N, Schaul S, Ibrahimi L, et al. Estrogen signaling in the dorsal raphe regulates binge-like drinking in mice. Translational Psychiatry. 2024 Feb 27;14(1).
3. Chen H, Lu Y, Xiong R, Rosales CI, Coles C, Hamada K, et al. Effect of a brain‐penetrant selective estrogen receptor degrader (SERD) on binge drinking in female mice. Alcoholism/Alcoholism, clinical and experimental research. 2022 May 29;46(7):1313–20.
4. Zallar LJ, Rivera-Irizarry JK, Hamor PU, Pigulevskiy I, Rico Rozo AS, Mehanna H, et al. Rapid nongenomic estrogen signaling controls alcohol drinking behavior in mice. Nature Communications [Internet]. 2024 Dec 30 [cited 2025 Feb 5];15(1). Available from: https://www.nature.com/articles/s41467-024-54737-6

The Complex Relationship Between Lifestyle, Socioeconomic Factors, and Alcohol Consumption

The formation of habits related to alcohol consumption transcends purely individual issues, reflecting complex interactions between neurobiological factors, sociocultural contexts, and socioeconomic determinants. Recent research indicates that although healthy behaviors are associated with lower risks of problematic consumption, only 3% to 12.3% of health disparities related to socioeconomic status can be explained by lifestyle choices. This suggests that effective approaches to preventing alcohol use disorders must consider both the neurobiological mechanisms of habit formation and broader social determinants.

An Integrated Analysis of Recent Studies

An integrated analysis of recent studies on alcohol consumption, habit formation, and sociocultural contexts reveals a complex web of factors influencing the development of consumption patterns and potential disorders. A meta-analysis published by Giannone and colleagues (2024) demonstrates how behaviors initially guided by goals can progressively transform into automatic habits with chronic consumption, becoming less sensitive to negative consequences.

From Conscious Choice to Habitual Behavior

The transition from voluntary behavior to automatic habit does not occur abruptly but rather gradually and probabilistically. Evidence from human studies and animal models indicates that alcohol can accelerate habit formation compared to other rewards, such as food. This neurobiological process helps explain why some individuals maintain harmful consumption patterns despite obvious adverse consequences.

In individuals with a history of heavy alcohol use, significant changes are observed in decision-making processes, with reduced engagement in goal-directed control and an increased tendency toward habitual behavior. It is important to highlight that, in advanced stages, this process can evolve into compulsivity, defined as the persistence of use even in the face of clearly identifiable punishments or adverse consequences.

Sociocultural Contexts as Determinants

Beyond neurobiological mechanisms, Sudhinaraset and collaborators (2016) demonstrate that problematic alcohol use results from the interaction of social, cultural, and environmental influences. Macro-level factors, such as marketing and public policies, interact with community elements, such as alcohol availability, and relational aspects, such as family habits and peer influence.

This social-ecological perspective is particularly relevant to understanding the specific vulnerabilities of certain population groups. Ethnic minorities and immigrants, for example, may face greater exposure to risk contexts such as discrimination and cultural adaptation stress. Paradoxically, maintaining certain cultural traditions of origin can act as a protective factor in some cases, highlighting the complexity of these interactions.

Lifestyle, Socioeconomic Status, and Health

A cohort study conducted by Zhang and collaborators (2021), analyzing data from over 440,000 adults in the United States and the United Kingdom, revealed that although unhealthy lifestyles are more prevalent among groups with lower socioeconomic status (SES), only a small fraction (3% to 12.3%) of the association between SES and negative health outcomes can be explained by these behaviors.

This finding has profound implications for public health policies: promoting healthy lifestyles, although beneficial across all social strata, is insufficient to eliminate health disparities associated with socioeconomic inequalities. Interestingly, data from the UK Biobank (a large prospective health database with information from approximately 500,000 UK participants) suggest that the protective effect of healthy habits may be even more pronounced among participants with lower SES, indicating potential windows of opportunity for targeted interventions.

Implications for Public Policies and Interventions

A multidimensional understanding of the factors influencing alcohol consumption has direct implications for the development of more effective public policies and clinical interventions. Approaches that consider only the total amount of alcohol consumed or focus exclusively on individual lifestyle choices, without addressing socioeconomic and contextual determinants, will have limited efficacy.

For Brazil, where approximately 18% of alcohol consumers adopt high-risk consumption patterns, integrated strategies that simultaneously address multiple levels of influence present greater potential for harm reduction.

Final Considerations

The relationship between lifestyle, socioeconomic factors, and alcohol consumption highlights the need for an expanded perspective on public health. The formation of alcohol-related habits cannot be understood solely as the result of individual choices but as a product of complex interactions among neurobiology, social context, and structural determinants.

Effective interventions must therefore combine approaches aimed at modifying individual habits with broader policies that address social determinants of health. For research, the ongoing challenge remains to develop models that adequately capture the complexity of these interactions and translate this knowledge into practical, culturally sensitive, and socially equitable strategies.

References:

1. Giannone F, Ebrahimi C, Endrass T, Hansson AC, Schlagenhauf F, Sommer WH. Bad habits--good goals? Meta-analysis and translation of the habit construct to alcoholism. Transl Psychiatry. 2024;14:298. doi: 10.1038/s41398-024-02965-1
2. Sudhinaraset M, Wigglesworth C, Takeuchi DT. Social and Cultural Contexts of Alcohol Use: Influences in a Social--Ecological Framework. Alcohol Research: Current Reviews. 2016;38(1):35-45.
3. Zhang YB, Chen C, Pan XF, et al. Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies. BMJ. 2021;372. doi: 10.1136/bmj.n604
4. Kim CH, Kang KA, Shin S. Healthy lifestyle status related to alcohol and food addiction risk among college students: a logistic regression analysis. Journal of American College Health. 2023;71(3):775-781. doi: 10.1080/07448481.2021.1908302

Emotional Differences: Moderate versus Abusive Alcohol Consumption

Differences in drinking patterns can influence how a person manages their emotions and even certain personality traits. Below, we explore recent scientific evidence showing how people who drink moderately differ emotionally from those who engage in abusive alcohol use, considering emotional regulation, personality traits, and individual factors involved.

Emotional Regulation and Stress Management

Why can some people consume alcohol moderately without problems, while others struggle to handle the substance? A key difference between moderate drinking and alcohol abuse lies in emotional regulation — that is, how a person manages feelings like stress, sadness, or anger. Studies indicate that individuals who abuse alcohol tend to have more difficulty dealing with negative emotions without drinking compared to moderate drinkers.¹ Often, excessive drinkers use alcohol as an “escape valve” for daily tensions, pointing to less efficient emotional regulation. Indeed, research with people undergoing treatment for alcohol dependence showed they have greater deficits in tolerating negative feelings than social drinkers.¹ On the other hand, moderate consumers usually do not rely on alcohol to cope with difficult emotions—they tend to use other coping strategies, maintaining better emotional balance without needing to get drunk. It is also worth noting that abusive use can worsen emotions in the long term: after binge drinking episodes, symptoms like heightened anxiety, irritability, and depressed mood during hangovers are common.²

Personality Traits and Impulsivity

Besides affecting how we handle emotions, drinking patterns are also linked to personality traits. People who abuse alcohol often display traits such as higher impulsivity and sensation-seeking, as well as a tendency to experience negative moods more frequently. Recent research points out that heavy drinkers tend, on average, to be less conscientious (i.e., less disciplined and organized) and less agreeable (possibly showing more hostility), in addition to having higher levels of neuroticism—a trait associated with emotional instability and a tendency toward anxiety and mood swings.³ In other words, those who abuse alcohol tend to be more impulsive and emotionally reactive. For example, some studies show that both moderate and some heavy drinkers tend to be somewhat more extroverted compared to abstainers, seeking socialization, but abusive drinkers are distinguished by higher impulsivity and lower self-control, which can lead them to exceed safe consumption limits.³ These impulsive personality traits may predispose individuals to excessive consumption and, at the same time, be aggravated by the habit of drinking excessively, creating a negative cycle.

Usage Pattern and Amount: Different Emotional Effects

The effect of alcohol on emotions also varies according to the amount ingested and the pattern of use. At low to moderate amounts, alcohol usually has a mild disinhibiting and anxiolytic effect—that is, it can reduce tension and promote a temporary feeling of relaxation and well-being. There is evidence that moderate use increases positive emotions and the feeling of social bonds—people become more relaxed and socially engaged after a small amount of alcohol.⁴ It is no coincidence that, in social contexts, moderate drinkers report feeling happier or more sociable. However, this effect has a limit. As the amount of alcohol increases (in abusive use), effects can become harmful: high levels of alcohol can cause abrupt mood changes, increased aggression, or exaggerated emotional reactions. Studies with young adults show that episodes of heavy drinking bring more negative consequences—such as regrets, arguments, or risky behaviors—without necessarily increasing positive sensations.⁵

In summary, abstainers or moderate drinkers tend to exhibit greater emotional balance, using alcohol in social contexts and showing more control over their impulses. Abusive use is associated with greater difficulty in emotional regulation, impulsivity, and mood swings. These differences are influenced both by the amount ingested and individual characteristics, such as how one copes with stress. Maintaining moderation helps protect not only physical health but also emotional well-being.

References:

1. Jakubczyk, A., Trucco, E. M., Kopera, M., Kobyliński, P., Suszek, H., Fudalej, S., Brower, K. J., & Wojnar, M. (2018). The association between impulsivity, emotion regulation, and symptoms of alcohol use disorder. Journal of substance abuse treatment, 91, 49–56. https://doi.org/10.1016/j.jsat.2018.05.004
2. van Schrojenstein Lantman, M., Mackus, M., van de Loo, A. J. A. E., & Verster, J. C. (2017). The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood. Human psychopharmacology, 32(5), e2623. https://doi.org/10.1002/hup.2623
3. Gmel, G., Marmet, S., Studer, J., & Wicki, M. (2020). Are Changes in Personality Traits and Alcohol Use Associated? A Cohort Study Among Young Swiss Men. Frontiers in psychiatry, 11, 591003. https://doi.org/10.3389/fpsyt.2020.591003
4. Sayette M. A. (2017). The effects of alcohol on emotion in social drinkers. Behaviour research and therapy, 88, 76–89. https://doi.org/10.1016/j.brat.2016.06.005
5. Patrick, M. E., & Terry-McElrath, Y. M. (2021). Drinking Motives and Drinking Consequences across Days: Differences and Similarities between Moderate, Binge, and High-Intensity Drinking. Alcoholism, clinical and experimental research, 45(5), 1078–1090. https://doi.org/10.1111/acer.14591

Alcohol and Cancer: Should Warning Labels Be Required on Alcoholic Beverages?

The World Health Organization (WHO) has released a document supporting the inclusion of cancer risk warnings on alcoholic beverage labels.

In early February 2025, the World Health Organization (WHO) issued a report endorsing the addition of cancer risk warnings on alcoholic beverage packaging¹ ².

According to the report, there is a concerning lack of public awareness in Europe about the link between alcohol and cancer. Alcohol is responsible for around 800,000 deaths each year in the WHO European Region, yet only a small portion of the population is aware of the risks. The WHO found that only 15% of people were aware of the link between alcohol and breast cancer, and just 39% knew of its connection to colorectal cancer. In response, the organization recommended implementing clear and prominent health warnings on alcoholic beverage labels—similar to those found on tobacco products—to help consumers make more informed decisions about their health.

Currently, only three of the 27 European Union (EU) member states have adopted warning labels on alcoholic drinks. Ireland is the only country that has passed specific legislation requiring labels to include health warnings about alcohol-related risks, including cancer. This measure will take effect in May 2026, mandating that packaging inform consumers about the dangers of alcohol use, such as liver disease and pregnancy-related risks. Other EU countries—such as France, Lithuania, and Germany—have some form of warning on alcohol labels, though not necessarily regarding cancer.

The WHO report suggests that labels should contain direct messages and possibly images to maximize impact and raise awareness of the risks associated with alcohol consumption.

Key Findings and Recommendations:

• Prominent health warnings: The WHO recommends clear and visible warning labels about cancer risks, potentially including text or pictograms to better inform consumers.
  
  
• Cancer-specific warnings: Studies show that labels mentioning cancer risks increase awareness and help reduce alcohol consumption.
  
  
• Limitations of QR codes: Only 0.26% of consumers scan QR codes for health information, reinforcing the need for visible, on-package warnings.
  
  

Alcohol and Cancer

In January of this year, U.S. Surgeon General Dr. Vivek Murthy issued a warning regarding alcohol consumption and its link to cancer³. The advisory summarized scientific evidence on the connection between alcohol and cancer, including the biological mechanisms involved. It concluded that alcohol consumption is one of the leading preventable causes of cancer in the U.S. and globally, accounting for approximately 100,000 cases annually in the U.S. and 750,000 worldwide.

The International Agency for Research on Cancer (IARC) has long acknowledged strong evidence of this link. Currently, the IARC classifies alcohol as a carcinogen that contributes to cancer in multiple parts of the body, including the oral cavity, oropharynx, hypopharynx, esophagus (squamous cell carcinoma), colon, rectum, liver, intrahepatic bile duct, larynx, and breast⁴.

References:

1. Alcohol labels should warn of cancer risk, says new WHO/Europe report [Internet]. Who.int. 2021. Available from: https://www.who.int/europe/news-room/14-02-2025-alcohol-labels-should-warn-of-cancer-risk--says-new-who-europe-report
2. Ferreira-Borges C, Daša Kokole, Galea G, Neufeld M, Rehm J. Labels warning about alcohol-attributable cancer risks should be mandated urgently. The Lancet Public Health [Internet]. 2025;0(0). Available from: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00040-4/fulltext
3. Alcohol and Cancer Risk [Internet]. HHS.gov. 2024. Available from: https://www.hhs.gov/surgeongeneral/reports-and-publications/alcohol-cancer/index.html
4. IARC Handbooks of Cancer Prevention Volume 20A: Reduction or Cessation of Alcohol Consumption [Internet]. www.iarc.who.int. Available from: https://www.iarc.who.int/news-events/iarc-handbooks-of-cancer-prevention-volume-20a-reduction-or-cessation-of-alcohol-consumption/

How Alcohol Affects Bipolar Affective Disorder

Bipolar affective disorder (BD) is a mental health condition characterized by mood swings, alternating between episodes of mania, hypomania, and depression. Alcohol consumption, especially in excess, can significantly worsen this condition. Studies show that individuals with bipolar disorder often also struggle with alcohol use disorder (AUD), a combination that tends to intensify symptoms and complicate treatment.

There is a strong link between BD and alcohol use disorders. Several surveys indicate that this comorbidity is quite common (1). This overlap is not mere coincidence; genetic and environmental factors can predispose individuals to both conditions. Unfortunately, having both bipolar disorder and alcoholism is associated with worse clinical outcomes than having bipolar disorder alone. For instance, patients with BD who also abuse alcohol tend to have an earlier onset of the disorder, more episodes throughout life, and higher rates of hospitalization. Overall, this combination is associated with a more complicated prognosis and greater functional impairment (2). In other words, alcohol tends to increase the severity of bipolar disorder, making the mood highs and lows harder to manage.

Long-term studies with bipolar patients show that increases in alcohol consumption are followed by worsening depressive and manic symptoms in the months that follow (2). Excessive alcohol use can disrupt neurotransmitters involved in mood regulation—such as GABA, glutamate, and dopamine—leading to more intense mood swings. Additionally, alcohol disrupts sleep quality and the circadian rhythm—both of which are crucial for mood stability. Alcohol also causes dehydration and physical stress, which can strain the body and trigger sudden mood changes. In summary, alcohol and bipolar disorder tend to feed into each other: alcohol worsens emotional instability, and instability can, in turn, lead to impulsive behaviors such as increased drinking. This interaction sustains a harmful cycle of relapse. Research confirms that when alcohol and bipolar disorder co-occur, they exacerbate one another, resulting in more severe manic and depressive episodes and a more difficult clinical course (3).

Alcohol and the Treatment of Bipolar Affective Disorder

Alcohol use not only worsens symptoms but also undermines the effectiveness of bipolar disorder medications. Mood stabilizers (like lithium, valproate, and carbamazepine), antipsychotics, and benzodiazepines can have reduced effectiveness or intensified side effects when combined with alcohol. For example, alcohol enhances the sedative effects of many psychiatric medications, leading to excessive drowsiness, poor motor coordination, and increased risk of accidents or falls. Alcohol also places additional stress on the liver, the organ responsible for metabolizing many medications; this can alter the drugs’ elimination, increasing the risk of toxic effects or, conversely, reducing their therapeutic concentration in the blood.

Another important issue is that alcohol consumption often leads to poor treatment adherence. Patients under the influence may forget to take their medication or choose to skip doses in order to drink, which disrupts the management of bipolar disorder. Even small amounts of alcohol can interfere with the consistency and routine required for effective treatment. In practice, alcohol makes it harder for patients to maintain the stability achieved with mood stabilizers and other medications. Large-scale studies on people with bipolar disorder emphasize that treating only the mood disorder while ignoring AUD leaves gaps in care, resulting in poorer treatment response and higher relapse rates (2). This is why healthcare professionals advocate for integrated approaches: ideally, both bipolar disorder and alcohol use should be treated simultaneously through counseling, psychotherapy, or specific medications for addiction. This integrated management increases the chances of success by addressing all aspects of the problem.

In conclusion, alcohol can have a profoundly negative impact on bipolar affective disorder, worsening symptoms and undermining treatment success. Because it is a legal and socially accepted substance, its risks are often underestimated—but in the context of bipolar disorder, experts strongly advise extreme caution. Avoiding alcohol, or seeking help to quit, is a crucial step for those living with bipolar disorder, as it contributes to a more stable and healthier life.

References:

1. Pozzolo Pedro, M. O., Pozzolo Pedro, M., Martins, S. S., & Castaldelli-Maia, J. M. (2023). Alcohol use disorders in patients with bipolar disorder: a systematic review and meta-analysis. International review of psychiatry (Abingdon, England), 35(5-6), 450–460. https://doi.org/10.1080/09540261.2023.2249548
2.  
   Sperry, S. H., Stromberg, A. R., Murphy, V. A., Lasagna, C. A., McInnis, M. G., Menkes, M. W., Yocum, A. K., & Tso, I. F. (2024). Longitudinal Interplay Between Alcohol Use, Mood, and Functioning in Bipolar Spectrum Disorders. JAMA network open, 7(6), e2415295. https://doi.org/10.1001/jamanetworkopen.2024.15295
3. Grunze, H., Schaefer, M., Scherk, H., Born, C., & Preuss, U. W. (2021). Comorbid Bipolar and Alcohol Use Disorder-A Therapeutic Challenge. Frontiers in psychiatry, 12, 660432. https://doi.org/10.3389/fpsyt.2021.660432

Use of Oral Contraceptives and Alcohol Consumption

Alcohol consumption among women has increased significantly in recent years, making it essential to understand how it interacts with the use of oral contraceptives.

Impact of Alcohol on the Effectiveness of Oral Contraceptives

Although there are no conclusive studies showing that alcohol directly reduces the effectiveness of oral contraceptives, excessive drinking may indirectly compromise their effectiveness. The main reason is that alcohol can cause a person to forget to take the pill at the correct time.

Another relevant factor is the impact of alcohol in cases of vomiting (1). If someone consumes large amounts of alcohol and vomits within two hours of taking the birth control pill, the medication may not be fully absorbed by the body, reducing its effectiveness.

In addition, excessive alcohol consumption, including episodes of binge drinking, is associated with a higher risk of medical complications such as blood clots in the lungs or legs (2). Some women are already at increased risk of developing clots due to the use of hormonal contraceptives, and heavy alcohol use can heighten that risk (2,3).

Importance of Contraceptive Choice and Medical Guidance

While alcohol does not appear to directly compromise the effectiveness of oral contraceptives, excessive consumption can affect adherence to the method and pose additional health risks. Besides the pill, there are other contraceptive methods that may be more suitable for some women, such as hormonal IUDs, implants, and contraceptive injections, which do not require daily administration and may be less prone to failure due to inconsistent use.

Therefore, it is essential for each woman to seek medical guidance to choose the contraceptive method that best suits her lifestyle and health history. Talking to a healthcare professional can help clarify questions about the possible impacts of alcohol and ensure a safe and effective contraceptive choice.

References:

1. Planned Parenthood. (2015, June 22). Does drinking alcohol affect how well my birth control works
2. Ballard, H. S. (1997). The hematological complications of alcoholism. Alcohol health and research world, 21(1), 42-52.

3. Shen, C. J., Kao, C. H., Hsu, T. Y., Chen, C. Y., Lin, C. L., & Shih, H. M. (2017). Effect of alcohol intoxication on the risk of venous thromboembolism: A nationwide retrospective cohort study. Medicine, 96(42), e8041.

Korean study highlights impact of frequent alcohol consumption on healthcare costs

Frequent alcohol consumption has a significant economic impact on healthcare systems, generating substantial additional costs and requiring specific public policies to reduce them. A recent study conducted in South Korea identified significant increases in healthcare costs associated with frequent alcohol consumption.

A recent study (1) conducted in South Korea analyzed data from a longitudinal cohort of 62,965 adults aged 40 to 69 years, with the aim of investigating the additional healthcare costs associated with frequent alcohol consumption. Using information collected by the National Health Insurance Service of Korea (NHIS-NSC), the study followed participants over a decade, allowing a detailed assessment of the costs related to different levels of alcohol consumption in the long term.

The results highlighted that frequent alcohol consumption has a significant economic impact on healthcare costs. Men who consumed alcohol almost daily had 21.4% higher costs compared to non-drinkers. Among women, the impact was even more significant, with an increase of 31.8%, corresponding to additional annual expenditures of up to US$433 for women and US$284 for men.

The study also showed that the frequency of consumption plays a crucial role in costs. Among men, moderate consumption (1 to 2 times per month or week) was associated with lower costs compared to non-consumers. However, as frequency increased to 3 or more times per week, health expenditures increased significantly.

These findings emphasize the relevance of public policies focused on reducing frequent and excessive alcohol consumption to alleviate the financial burden on health systems.

Based on the findings, some practical recommendations are important:

1. Strengthen educational campaigns on the economic and health risks related to frequent and excessive alcohol consumption.

1. Implement preventive programs and specific interventions for groups that consume alcohol almost daily.

1. Promote strategies for responsible consumption, especially among vulnerable groups, such as women and older adults.

References:

1. Kim Y. The effects of smoking, alcohol consumption, obesity, and physical inactivity on healthcare costs: a longitudinal cohort study. BMC Public Health. 2025;25:873. https://doi.org/10.1186/s12889-025-22133-4..

Wine Consumption and Health: Study Suggests Protective Effect of Polyphenols Against Metabolic Syndrome

A recent study investigated the relationship between the consumption of polyphenols, found in foods and beverages such as wine, in the diet and the risk of metabolic syndrome in Brazilian adults. The findings indicate that higher intake of polyphenols is associated with a lower chance of developing metabolic syndrome, suggesting that diets rich in these substances may play a protective role against cardiometabolic risk factors.

A study (1) conducted using data from the Longitudinal Study of Adult Health (ELSA-Brazil) analyzed the association between polyphenol intake (found in foods such as fruits, coffee, chocolate, and wine) and the incidence of metabolic syndrome, considering cardiometabolic risk factors. Metabolic syndrome is a cluster of risk factors, such as abdominal obesity, hypertension, altered cholesterol levels, and high blood glucose, that increase the likelihood of heart disease, type 2 diabetes, and other health problems. Treatment and prevention are based on lifestyle changes, such as healthy eating, physical activity, and weight management.

The research evaluated 6,387 participants, with a mean age of 49.8 years, of whom 65% were women. Dietary intake was estimated using a semi-quantitative Food Frequency Questionnaire, and polyphenol intake was calculated using the Phenol-Explorer database.

Key Findings
Metabolic syndrome was defined according to the Joint Interim Statement criteria, and associations between polyphenol intake and cardiometabolic risk factors were assessed using logistic regression. During a median follow-up of 8.19 years, 2,031 participants developed metabolic syndrome. Individuals in the higher tertiles of total polyphenol intake had a lower risk of metabolic syndrome compared to those in the lowest tertile. After adjusting for sociodemographic factors, lifestyle, and diet, the risk was 22% lower in the second tertile and 23% lower in the third tertile of polyphenol intake (T2 vs. T1: OR 0.78 [95% CI: 0.68-0.90]; T3 vs. T1: OR 0.77 [95% CI: 0.66-0.90]).

Additionally, inverse associations were observed between the risk of metabolic syndrome and the consumption of phenolic acids, lignans, stilbenes, and other polyphenols. Although total flavonoid intake did not show a significant association, subclasses such as flavan-3-ols (monomers and polymers) demonstrated a protective effect. Total polyphenol intake was also inversely associated with waist-to-hip ratio, systolic and diastolic blood pressure, HOMA-IR, triglycerides, and C-reactive protein, while showing a positive association with total cholesterol, LDL, and HDL.

Implications and Limitations of the Study
The findings reinforce the importance of polyphenol-rich diets, such as those based on fruits, vegetables, and other natural foods, in reducing cardiometabolic risk. Adopting dietary habits that prioritize sources of polyphenols may contribute to strategies for preventing metabolic syndrome and promoting cardiovascular health. Furthermore, these results could support nutritional recommendations and public policies aimed at improving the food quality of the Brazilian population.

However, some caveats should be considered:

• The study assessed dietary habits at a single point in time, which may not reflect changes over time.
• Individuals with higher cardiometabolic risk may have adopted healthier diets during the study, influencing the results.
• Consumption of these foods should follow a nutritional profile: fruits can be consumed in larger quantities, while chocolates and wines should be consumed in moderation.
• The analysis used Odds Ratio (OR) in a longitudinal study, whereas Relative Risk (RR) or Hazard Ratio (HR) would be more appropriate, as OR tends to inflate results for common outcomes.

Conclusion
The findings suggest that the consumption of polyphenols, including those present in red wine, may be associated with a lower risk of metabolic syndrome and its components. However, the role of wine in health should be evaluated within the context of a balanced diet and within the limits of moderate alcohol consumption.

References:

1. Carnauba RA, Sarti FM, Coutinho CP, Hassimotto NMA, Marchioni DM, Lotufo PA, Bensenor IM, Lajolo FM. Associations between polyphenol intake, cardiometabolic risk factors and metabolic syndrome in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Nutr [Internet]. 2024 Nov 26. Disponível em: https://doi.org/10.1016/j.tjnut.2024.11.016.

American Research Suggests Semaglutide May Help Reduce Alcohol Cravings and Consumption

A recent clinical trial conducted in the United States investigated the impact of semaglutide, a medication used to treat diabetes and obesity, on reducing alcohol consumption. The findings suggest that the use of this medication may help decrease both the craving for and the amount of alcohol consumed, opening new perspectives for the treatment of alcohol use disorder (AUD).

A new study (1) published in JAMA Psychiatry suggests that semaglutide, a drug originally developed for diabetes and obesity, may also have a positive impact on reducing alcohol consumption. The study was a phase 2 randomized clinical trial conducted in the United States, involving adults diagnosed with alcohol use disorder (AUD). The results showed that weekly doses of semaglutide helped reduce alcohol consumption and the craving for alcoholic beverages.

The study included 48 participants who were not seeking treatment for AUD. They were divided into two groups: one receiving semaglutide and the other a placebo. After nine weeks of treatment, participants who used semaglutide consumed significantly less alcohol than those in the placebo group. The study also showed a reduction in binge drinking episodes and a decrease in the desire to drink.

How Can Semaglutide Influence Alcohol Consumption?

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 receptor agonists (GLP-1RAs), which affect appetite regulation and the brain's reward system. Preclinical studies had already suggested that GLP-1RAs could influence alcohol consumption behavior by reducing the pleasure associated with drinking.

In the clinical study, participants treated with semaglutide consumed less alcohol when subjected to a laboratory test of self-administration of alcoholic beverages. The researchers also noted that semaglutide did not directly affect the number of days participants drank, but it reduced the amount consumed per drinking day.

Possible Clinical Implications

Although the results are promising, the authors highlight that larger studies are needed to confirm the findings and assess the safety of long-term use of semaglutide for treating AUD. Currently, less than 10% of individuals with alcohol use disorder receive pharmacological treatment. If its effectiveness is confirmed, semaglutide could become a new option for people who want to reduce alcohol consumption without completely abstaining.

What Does This Mean for Those Who Want to Reduce Alcohol Consumption?

If you are concerned about your alcohol consumption pattern, it is important to speak with a healthcare professional before considering any medication. The study suggests that semaglutide may help reduce alcohol consumption, but it is not a universal solution. Other approaches, such as cognitive-behavioral therapy and social support, remain essential for managing AUD.

With more research, semaglutide may represent an innovative therapeutic option in the future. For now, the best strategy for maintaining balanced alcohol consumption remains self-awareness, moderation, and professional support.

References:

1. Hendershot CS, Bremmer MP, Paladino MB, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025. doi:10.1001/jamapsychiatry.2024.4789.