The preventive Role of Topical Timolol in Treatment of Migraine Headaches

Abstract

Background: There are many various hypotheses about pathophysiology of migraine headaches. One of them is autonomic nervous system disturbance, but the exact location of the disturbance is not well known. Since most of migraine attacks are accompanied with a retro-orbital pain, we assessed the efficacy and safety of topical Timolol on blockage of β adrenergic receptors for preventing migraine headaches. Methods: In a clinical trial study, 43 migraine patients (7 male and 36 female) were studied in two neurology clinics in Isfahan. Timolol maleate (5% eye drop) prescribed twice a day. The patients visited weekly for the first 4 weeks; then 8th and 12th week after the beginning of treatment, and the duration and frequency of attacks were evaluated. The severity of headache measured subjectively. Results: The patients were aged 14 to 54 years, with mean age of 34.2 years and mean disease duration of 9.5 years before the study. They had 13.1 headache days per month. After treatment, the frequency of attacks reached to 3.4 attacks per month. The mean duration of each attack were 16.4 hours before treatment and 2.1 hours after treatment by using Timolol eye drop which were significantly different (P<0.001). The severity and duration of attacks also decreased after 12 weeks. None of them have reported adverse events after using it. Conclusion: Timolol maleate eye drop is an effictive, well-tolerated, safe, and easy-to-use prophylactic antimigraine medication. Key Words: Migraine headaches; Autonomic nervous system; Timolol