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Beta Blocker Eye Drops May Alleviate Migraine Pain

Two Kansas City ophthalmologists report on an inexpensive, effective way to treat migraine: widely available beta blocker eye drops, usually used to treat glaucoma.

In the course of their research, Carl V. Migliazzo, MD, and John C. Hagan, III, MD, worked with 7 female patients who used the eye drops at the first sign of migraine symptoms. The subjects used this treatment over a multi-year period, and the patients reported nearly complete pain relief with the drops and few side effects.

The authors note that daily use of oral beta blocker agents are used routinely for chronic migraine prevention. These drugs, however, do not stop acute onset migraines after symptoms have begun. The drops are effective, the authors believe, because the beta blocker passes into the nasal cavity and is quickly absorbed into the system of blood vessels. Within a few minutes the blood level of beta blocker is increased sufficiently to stop the escalating migraine headache. This action would explain the success of the beta blocking eye drops and the failure of the oral medications, as delivery through the eyes and is much quicker than through the gastrointestinal system.

As with many pharmaceutical treatments, the eye drops may not be indicated for all patients, including individuals with asthma, other breathing problems, and some eye problems. The authors also stress that beta blocker eye drops for acute migraine attacks should not be used except under the direction of physicians familiar with their use.

The study, with only 7 participants, was quite small, but if larger placebo-controlled studies would provide similar results, the authors say the drops—inexpensive and available worldwide—would be a welcome addition to migraine therapy.

Dr. Hagan is also the editor of Missouri Medicine, the peer-reviewed journal in which the article appeared. In an accompanying editorial, he noted that medical literature first carried reports of successful headache treatment with beta blocker drops in 1980. Since then, other reports have also been published, with calls for additional study. So far that study has not been undertaken, Dr. Hagan said, and given that the drops are available generically, the pharmaceutical industry has little incentive to fund such studies. He notes that the National Institutes of Health is offering funding for novel treatments of migraine, and believes research into the eye drops for migraine should be pursued.

“Actually, it’s long overdue for prospective, masked, controlled, randomized, adequately statistically powered studies to prove or disprove whether beta blocker eye drops are useful for treating acute, even chronic migraines,” he wrote.

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