Is Alcohol Harmful for Patients with Multiple Sclerosis

Objective: Alcohol consumption has been linked with increased risk and worse outcomes in multiple sclerosis (MS). However, the results are not uniform and conflicting data on the matter have been published. This systematic review addresses the association of alcohol with increased risk and worse outcomes in MS. Method: Systematic review of the literature, searching for the terms "Alcohol" AND "Multiple Sclerosis" OR "MS" in the Medline, PubMed, Lilacs, SciELO and Google Scholar databases. References from selected articles were used to identify studies that might not previously have been recognized as pertinent to this review. The period established for searching for articles started in 1983, after publication of Poser’s criteria for diagnosing MS and finished on July 31, 2016. Results: The initial search identified 1399 potential papers from the search terms selected. After exclusion of duplications and articles that did not fulfil the criteria of the review, 30 papers were selected for full-text discussion. Eleven research articles published between 2004 and 2016 were included in this review. Alcohol consumption was considered to be a risk factor for development of MS by some authors but not by others. Some studies even reported that drinking small amounts of alcohol had a protective effect against developing MS. Alcohol seemed to have a negative effect on disability progression in MS. Data from different countries and cultures may have played a role in the results from the studies. Conclusion: It has been suggested that alcohol use might be related both to bad and to good outcomes in MS. There are no recommendations on doses that might be acceptable.