Eye drops containing the beta-blocker timolol alleviate head pain in the majority of migraine attacks, say the Indian authors of a small trial.

In the randomised, masked placebo-controlled crossover trial involving 50 patients, the authors reported that 233 timolol-treated attacks (82%) were associated with a clinically significant reduction in pain scores 20 minutes after instillation of the eyedrops, compared with 38 placebo-treated attacks (14%).

Participants (84% female, mean age 27 years) were randomised to either timolol maleate ophthalmic solution (0.5%), or placebo artificial tears over a three-month treatment period, and then, after a one-month washout period, were crossed-over to the opposite group, with 38 completing the study.

The patients were instructed to use one drop of their assigned medication in each eye at the earliest onset of migraine aura or headache and to use another drop at 10 minutes if there was no pain relief with the first drop.