A Randomized, Double-Blinded, Placebo-Controlled, Cross Over Study Evaluating the Efficacy and Safety of Timolol Ophthalmic Solution as an Acute Treatment of Migraine

Authors

  • Dipika Aggarwal, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Andrew J. Heim, CCRP University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Brennen Bittel, D.O. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Deetra Ford, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Richard Dubinsky, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Gary Gronseth, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Vernita Hairston, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Patrick Landazuri, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Fred Sachen, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Laura Herbelin, CCRP University of Kansas Medical Center, Kansas City, KS, Department of Neurology
  • Richard J. Barohn, M.D. University of Kansas Medical Center, Kansas City, KS, Department of Neurology

DOI:

https://doi.org/10.17161/kjm.v13i.13495

Keywords:

Migraine, Headache, Beta-blocker, Opthamolic

Abstract

Introduction. Daily oral beta-adrenoreceptor antagonist has been shown to be effective in preventing migraine headaches. Timolol 0.5% ophthalmic solution is a non-selective beta-adrenoreceptor antago- nist, where the primary use is for glaucoma. There have been case reports that timolol is effective in aborting or improving an acute migraine headache. The objective of this study was to assess the efficacy (decrease of ≥ 50% in pain scale at 120 minutes) of timolol 0.5% ophthalmic solution compared to placebo in acute treatment of migraine headache.

Methods.We performed a randomized, double-blind, crossover, placebo-controlled, study. Study entry criteria required subjects to have one to eight migraine episodes per month. The primary outcome was comparison of the change in a visual analog pain scale (VAS) at 120 minutes after taking the study medication. Study subjects were given a pain scale with a range of 1 (no pain) to 10 (most severe pain) to complete after onset of migraine but before administration of study drops and 120 minutes after administration of study drops. Improve- ment was defined as a ≥ 50% decrease in pain scale.

Results. Nineteen subjects completed the study and were used for analysis. The primary outcome changes in pain scale, 120 minutes after dose, showed a similar decrease for placebo and drug with a slightly wider 95% CI for placebo. Six subjects in each arm experi- enced a ≥ 50% decrease in pain scale.

Conclusion. These results support that timolol 0.5% ophthalmic solution is not an efficacious treatment for acute migraine headache.

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Published

2020-02-26

How to Cite

Aggarwal, D., Heim, A. J., Bittel, B., Ford, D., Dubinsky, R., Gronseth, G., Hairston, V., Landazuri, P., Sachen, F., Herbelin, L., & Barohn, R. J. . (2020). A Randomized, Double-Blinded, Placebo-Controlled, Cross Over Study Evaluating the Efficacy and Safety of Timolol Ophthalmic Solution as an Acute Treatment of Migraine. Kansas Journal of Medicine, 13, 2–5. https://doi.org/10.17161/kjm.v13i.13495