Aurora J. A. E. van de Loo

The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood

Hangover research often records the presence and severity of symptoms experienced the day after heavy alcohol consumption. However, usually no information is gathered on the impact of experiencing these symptoms on mood, cognition, and physical activities.

Hangover resistance in a Canadian University student population

Background Resistance to alcohol hangover may be a risk factor for alcohol use disorder. Previous research to establish the prevalence of hangover resistance in a drinking population has either not used comparable intoxication levels or has considered hangover resistance over a limited time frame. The purpose of this study was to examine the prevalence of lifetime hangover negative (LHN) drinkers across comparable eBAC values ranging from 0 to 500 mg/dl. Methods Students at an eastern Canadian university were surveyed about their heaviest drinking episode in the past month and indicated whether they had ever experienced a hangover in their lifetime (LHN) and, if they had, the hangover severity they experienced the next day. eBACs were calculated and the percentage of LHN drinkers was computed at each 10 mg/dl eBAC increment from 0 to 500 mg/dl. Results Most LHN drinkers (58% female, 71% male) had an eBAC on their heaviest drinking occasion below 80 mg/dl. Above eBACs of 80 mg/dl, 5.8% of female and 5.1% of male drinkers were lifetime hangover negative. Conclusions The results suggest that only a small percentage of heavy drinkers lay claim to being lifetime hangover negative.

Middle-of-the-night administration of sleep medication: a critical review of the effects on next morning driving ability

STUDY OBJECTIVES Sleep maintenance problems are common, hence treatments enabling patients to fall asleep more rapidly after middle-of-the-night (MOTN) awakenings, without impairing next morning alertness, are needed. This literature review compares the effects of MOTN administration of various hypnotics on morning driving ability, a potentially dangerous daily activity under conditions of impairment. METHODS A literature search was conducted identifying on-the-road driving studies examining the effects of MOTN administration of hypnotics on morning driving performance. In a standardized 100-km highway driving test in normal traffic, subjects were instructed to drive with a steady lateral position and constant speed of 95 km/h. The primary outcome measure of the driving test is the Standard Deviation of Lateral Position (SDLP, cm), i.e. weaving of the car. RESULTS Four driving studies were identified. Driving performance after MOTN administration of traditional benzodiazepine hypnotics was not examined. Zolpidem (10 mg and 20 mg, oral immediate release tablets) significantly impaired driving in a dose-dependent manner, when tested 4 hours after MOTN administration. Also, gaboxadol (15 mg) and zopiclone (7.5 mg) significantly impaired next-morning driving after MOTN administration. In contrast, sublingual zolpidem (3.5 mg) and zaleplon (10 mg and 20 mg) did not significantly affect driving 4 hours after MOTN administration. CONCLUSION Driving was not affected 4 hours after MOTN administration of sublingual zolpidem (3.5 mg) or zaleplon (10 mg and 20 mg). Significant driving impairment was found after MOTN administration of zolpidem (10 and 20 mg), gaboxadol (15 mg), and zopiclone (7.5 mg).

Mental resilience, perceived immune functioning, and health

Background Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status. Methods A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ), and questions regarding their perceived health and immune status. Results When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health (r=0.233, p=0.0001), perceived immune functioning (r=0.124, p=0.002), and IFQ score (r=−0.185, p=0.0001). Conclusion A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health.

The breathtaking truth about breath alcohol readings of zero

INTRODUCTION It has been postulated that the hangover state starts when breath alcohol concentration is zero. METHODS Data from 2 studies that assessed ethanol in breath, blood and urine were compared. RESULTS The data revealed that ethanol may still be present in the blood and urine during the hangover state, despite breath analyser readings of zero. DISCUSSION As ethanol is still present in the body despite zero breath alcohol readings, the current consensus to postpone cognitive testing in hangover studies until breath alcohol concentration is zero should be reconsidered.

The effects of alcohol mixed with energy drink (AMED) on subjective intoxication and alertness : results from a double-blind placebo-controlled clinical trial

The purpose of this double blind placebo controlled study was to examine if specific effects on subjective intoxication and alertness–sleepiness ratings could be demonstrated after consuming alcohol mixed with energy drink (AMED) when compared to consuming alcohol only (AO).

Mirtazapine as positive control drug in studies examining the effects of antidepressants on driving ability

The development of effective and safe antidepressant medications is ongoing, and driving studies are critical to assess a drugs safety. The current review summarizes the effects of a sedating effective antidepressant, mirtazapine, on driving ability, and its potential to serve as positive control drug in future driving studies. Three on-road driving studies and four driving simulator studies of mirtazapine were identified. The studies, conducted in healthy volunteers, showed a significant dose-dependent driving impairment, the first day following bedtime administration of mirtazapine. The magnitude of impairment after a single dose of 15 mg or 30 mg mirtazapine was comparable to that observed with a blood alcohol concentration of 0.05%, the legal limit for driving in many countries. After 1 or 2 weeks of daily treatment with mirtazapine, partial tolerance developed to mirtazapines effects on driving. Driving studies conducted in patients were less informative, as the effect on driving caused by mirtazapine was obscured by a drug-disease interaction and increased variability in patient groups. In conclusion, mirtazapine is useful as positive control drug to assess the potential effects of new antidepressant drugs on driving. Studies in normal healthy volunteers are more sensitive to drug effects than studies in patient populations.

The Green Light on Ketamine: Considerations for On-Road Safety

Ketamine (2-(2-chlorophenyl)-2-(methylamino) cyclohexanone) is a phenylcyclidine derivative originally developed in the 1960’s as a medication to initiate and maintain optimum anaesthesia in veterinary and paediatric surgery [1]. Ketamine functions as an N-methyl-d-aspartate (NMDA) receptor antagonist, and in low or sub-aesthetic doses, has proven efficacy as an analgesic, sedative, and novel antidepressant [2]. The administration of ketamine reliably produces dose-related deficits in several functional cognitive domains, and the associated psychoactive properties of the substance have been described in some detail [3-5]. Despite this, the impact on translatable facets of neurobehavioural functioning associated with ketamine use, such as driving ability, is not well described, and thus assumptions regarding the implications of the use of this drug on measures of traffic safety are equivocal [6]. Epidemiological studies have noted an increase in both the clinical application and concurrent recreational use of ketamine, and thus effective assessments of both the direct and peripheral effects of this substance are of high clinical importance. Ketamine has been used extensively among clinical settings for its analgesic and anesthetising properties, and emerging research has promoted the use of the substance for its antidepressant effects [7]. Pharmacologically, ketamine acts as a non

Susceptibility to Alcohol Hangovers: The Association with Self-Reported Immune Status

Increasing evidence points at a role for the immune system in the genesis of the alcohol hangover. This study investigated the association between self-reported immune function and experiencing hangovers. Dutch students aged 18 to 30 years old were invited to complete an online survey. Eighteen items on immune-related complaints were completed to assess self-reported immune function. Alcohol consumption in the past month (with respect to usual consumption and the occasion of heaviest drinking) was also recorded. Subjects with an estimated blood alcohol concentration (eBAC) of 0.18% or higher on their heaviest drinking occasion in the prior month were included in the analyses. Self-reported immune function was compared between drinkers with a hangover and those who claimed to be hangover resistant. In total, of 481 subjects (79.2% women) with a mean (SD) age of 21.1 (1.9) years old were included in the analysis. Of these, 83.3% (n = 400) reported having hangovers and 16.8% (n = 81) claimed to be hangover resistant. Drinkers with hangovers had significantly higher self-reported overall immune function scores when compared to hangover-resistant drinkers (mean ± SD = 10.5 ± 3.6 versus 13.1 ± 4.9, p = 0.0001), indicating a poorer immune status. In conclusion, experiencing alcohol hangovers is associated with significantly poorer self-reported immune function.

Susceptibility to Alcohol Hangovers: Not Just a Matter of Being Resilient

Introduction Although most drinkers have experienced a hangover the day following heavy alcohol consumption, a minority claims to be hangover resistant despite consuming the same large quantities of alcohol as those reporting alcohol hangover. The aim of the current study was to examine if susceptibility to experiencing hangovers is related to a drinkers interpretation of wellbeing and psychological assets to bounce back. Methods A survey was conducted among 2295 Dutch students assessing their past month alcohol consumption patterns, and measuring mental resilience and wellbeing. Estimated peak blood alcohol concentration (e-pBAC) for their heaviest drinking occasion in the past month was computed for each participant. Data from participants who reported a past month hangover, i.e. hangover sensitive drinkers, were compared with hangover resistant drinkers. The analyses were conducted for (a) all participants reaching an e-pBAC ≥ 0.11% (N = 986, of which 24.6% claimed to be hangover resistant) and (b) participants reaching an e-pBAC ≥ 0.18% (N = 480, of which 16.7% claimed to be hangover resistant). Results For both e-pBAC cut-off values, no significant differences between hangover sensitive and hangover resistant drinkers were found for mental resilience and wellbeing. Conclusion The current findings suggest that having a hangover is not simply an expression of poor psychological coping with the next-day consequences of heavy alcohol consumption.