Eye drops used for glaucoma may help treat migraines
Timolol eye drops alleviated the pain in most patients with migraines, according to a small study recently published in JAMA Neurology.
“Several oral [beta]-blockers are U.S. Food and Drug Administration-approved for migraine prophylaxis, but their gradual absorption and modification by first-pass metabolism delays effective plasma levels for hours to days, limiting their use in acute migraines,” Matthew Cossack, MD, of the University of Missouri, Kansas City School of Medicine, and colleagues wrote.
“Timolol eye drops provide a rapid route of delivery with the maximum plasma concentration achieved within 15 minutes of administration. This pharmacokinetic advantage supports a potential role for timolol eye drops in managing acute migraine,” they continued.
Researchers evaluated 198 migraine attacks from 10 adult patients who were asked to rate their migraine attacks on a scale of 0 to 3 in terms of severity and the effectiveness of each drop of timolol on a scale of 1 to 4 to assess its value as an add-on treatment.
Four participants found timolol highly effective vs. placebo while one participant did not, according to Cossack and colleagues. In addition, 67% of the migraines had severity scores of none or mild at 2 hours after timolol use vs. 78% of the severity scores after placebo use. Although one participant developed a branch retinal artery occlusion while using placebo, researchers said it was not related to the study. No other adverse events, including bradycardia or hypotension, were observed.
“This pilot study successfully explored the effect size of timolol eye drops on migraine headaches. Several participants responded extremely well to the timolol,” Cossack and colleagues wrote. “Further research is needed to determine what patient factors might predict responsiveness to timolol ... and at what dosage.” – by Janel Miller
Disclosures : The authors report no relevant financial disclosures.