CITY — For migraine sufferers who’ve had a hard time
taming the throbbing pain of migraine attacks, two Kansas
City-area eye doctors are suggesting a new route to relief.
the eye drops that they’ve prescribed routinely for years to
their glaucoma patients. Although more research is needed, for
at least some people one or two drops in each eye just at the
start of an attack appears to stop migraines in their tracks,
the doctors say.
latest edition of the journal Missouri Medicine,
ophthalmologists Carl V. Migliazzo and John C. Hagan detail
the experiences of seven patients who’ve gotten complete or
nearly complete relief from their migraines by taking the eye
the patients are women, as are most migraine sufferers. Some
use the eye drops alone; others take them along with
conventional pain medications. All had suffered from migraines
for years, even decades, before trying the eye drops.
61-year-old in their report has had migraines for about 30
years. They start on the right side of her head with throbbing
pain that radiates to her neck and shoulders. Left untreated,
the migraines can last as long as two days.
woman had tried medications but had stopped taking them
because they didn’t provide enough relief. The eye drops,
she said, eliminated the pain.
said he discovered this use for the drops through serendipity
more than a decade ago. One of his specialties is glaucoma, a
condition in which fluid buildup in the eyes can destroy
vision. The drops reduce production of the eye fluid, and
Migliazzo prescribed them routinely.
would report to me spontaneously. ‘You know, doctor, my
headaches started getting better after I started on this
medication,’" he said.
then, Migliazzo has prescribed them to eye patients who
complain about migraines. He has recommended them to nurses
with whom he works.
wife uses them," he said. "She swears by them. She
keeps them in her purse."
eye drops can’t be considered a sure thing, as the doctors
themselves are quick to admit.
and Hagan haven’t reported any data on how often the eye
drops actually work. And among the patients who said they were
helped, there’s always the possibility that the placebo
effect played a role in turning the eye drops into a migraine
killer — even sugar pills can reduce pain if you’re told
ahead of time that they will be effective.
results like this aren’t really science," Migliazzo
said. "It’s all anecdotes, and anecdotes people don’t
pay much attention to."
wants to see the eye drops put through controlled studies,
where migraine sufferers get the real drops or
"sham" placebo drops so the effects can be compared.
"It doesn’t have scientific validity unless it’s
controlled," he said.
attacks may start with flashes of light or visual disturbances
that give the appearance of looking through a broken mirror.
Then comes pain, like an explosion in the head. Along with the
throbbing headaches may come nausea and vomiting.
are about 38 million migraine sufferers in the U.S. That
includes about 18 percent of women and 6 percent of men. While
some people experience migraines only occasionally, chronic
sufferers may have several per month or many more.
dozens of medications used to treat migraines range from
over-the-counter ibuprofen to prescriptions that can run more
than $30 per pill. But patients often have a hard time finding
satisfactory relief. They may try alternative treatments such
as acupuncture, chiropractic care, special diets, even copper
survey found that nearly 80 percent of migraine sufferers were
willing to try new treatments.
drops may have a number of things going for them. Their long
history in eye patients has shown that they’re safe, and the
side effects, aggravating asthma and lowering the heart rate,
are already well known. And they’re cheap. The drops go for
about $4 per bottle, a small fraction of the cost of some
popular migraine medications.
also is a reasonable scientific explanation for why the eye
drops may work, and that’s attracting the attention of
researchers. Hagan has been in contact with a neuroscientist
in Luxembourg about pursuing a study. And a neurologist at the
University of Kansas Medical Center also is expressing
feel it would be a good project for our team," said KU
neurologist Manoj Mittal. "It has a good rationale behind
because the drops contain beta blockers, a group of drugs
first developed to treat high blood pressure and other heart
another case of medical serendipity, beta blocker pills have
become a first-line drug for the prevention of migraine
headaches. During a study of one beta blocker, a patient told
researchers that he not only had fewer chest pains, but fewer
migraines as well. His migraines returned only after he was
switched to a placebo.
percent of migraine sufferers who take beta blocker pills are
able to reduce the number of migraines they experience each
month by more than half.
research has failed to show any benefit from the pills for
stopping migraine attacks once they’ve started.
blocker pills may not get into the bloodstream fast enough to
stop a migraine, Mittal said. But the eye drops quickly drain
into the nose, where they’re rapidly absorbed into the
bloodstream through the mucus membrane.
you can get something in their system as soon as possible, you
have a better chance" to stop migraine attacks, Mittal
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would like to run tests to see what dose of the eye drops is
most effective, and whether it’s quicker and safer to put
the drops in the eyes, under the tongue or sprayed into the
nose. After those questions are answered, it will be time to
match the eye drops against a placebo to see how well it
sounds like it deserves further study. It may be an
inexpensive way to treat an attack," said Cathy Glaser,
founder and president of the Migraine Research Foundation.
"But is it a slam dunk? No. I don’t think so."
are many kinds of migraines with many different symptoms, so a
variety of drugs is required, Glaser said.
said Mittal and other researchers who want to study the eye
drops may find it hard to get funding.
blocker eye drops are old generic drugs. Pharmaceutical
companies are unlikely to invest in research that won’t give
them a drug they can market exclusively, she said.
largest source of government funding for medical research, the
National Institutes of Health, budgeted only $19 million for
migraine research last year, Glaser said. "We need more
money in the field."
still hopeful that someone will pursue the research needed to
determine the eye drops’ value. Before the article that he
and Migliazzo published, doctors in four previous case reports
in medical journals going back to 1980 said they had success
treating migraines with the beta blocker drops. None led to
might help a lot of people," Hagan said. "But no one
has picked up the torch and run with it."