Aims: This study sought to clarify if Alexander the Great indulged pathologically in alcohol and whether it contributed to his death.
Design: The texts of the historians Diodorus of Sicily, Plutarch, Arrian, Curtius Rufus, Athenaeus, Aelian and Justin were studied, with their information concerning wine consumption by Macedonians, and especially Alexander, and were evaluated. The surviving historical texts, all later than Alexander's epoch, are based on a series of contemporary histories and especially on the 'Royal Journals', an official diary written in the imperial court.
Findings and conclusions: Alexander consumed large quantities of undiluted wine periodically, reaching pathological intoxication. However, the existing data do not provide convincing evidence that Alexander the Great manifested abuse of or dependence on alcohol according to DSM-IV or ICD-10 criteria and it seems unlikely that alcohol was involved in his untimely death.