Migraine drugs, A to Z: timolol eye drops
Propranolol (Inderal) and other blood pressure medications in the beta blocker family are effective for the prevention of migraines. In a previous post 4 years ago I mentioned a report of 7 patients whose migraines were aborted with beta blocker, timolol, eye drops that are used to treat glaucoma.
The same group of doctors at the University of Missouri, Kansas City conducted a double-blind crossover study of timolol eye drops for the treatment of acute migraines. The results of the trial were published this month in JAMA Neurology. The treatment consisted of 4 drops of 0.5% timolol (this compares with 10 to 30 mg dose taken orally. Ten patients treated almost 200 migraine attacks. Four participants found timolol highly effective compared with placebo and one patients rated placebo as highly effective compared with timolol. No side effects were observed.
Instilling timolol eye drops is not likely to become widely used for the treatment of acute migraines. However, this treatment maybe worth trying in patients who do not respond or do not tolerate triptans and NSAIDs.
Thank you Dr. Mauskop. My doctor did say it would be ok but it seemed like a new concept to him and he had previously been unaware of some aspects of the medication so I was a little hesitant (also the whole Visine drops being deadly if taken orally thing).
You may want to ask your doctor since I don’t know your medical history. But in general, it’s safe to take eye drops by mouth.
My doctor prescribed me timolol maleate for my migraines. I am just trying to doubly confirm that I can use these eye drops sublingually because that would be my preferred method of use. Is that how they were given to patients in the test? i.e. the exact same drops that are prescribed for the eye were administered under the tongue? Thank you
I am one of two authors of the original series of 7 patients responding to beta blocker eye drops for acute migraine. Subsequently we have collected over 50 additional successfully treated patients. The drops work well taken under the tongue also (sublingual). The problem is Big Pharma is not interested in funding a medication that is effective, safe and relatively inexpensive. Can also be used with other common acute migraine medications. Moreover beta blockers in properly selected patients are safe. They also lower the pulse and blood pressure and reduce anxiety. If there are any smaller pharmaceutical companies interested in doing larger phase 1 studies please contact me.