One of my friends suffers from migraine headaches.

If she does not get medicine on board immediately with symptom onset, days of misery ensue.

Migraine is a debilitating neurological disease that affects over a billion people worldwide, with those assigned female at birth significantly more likely to experience it than men (21 versus 10 percent).

This common condition often hits young people the hardest, leading to missed days at work and school, reduced productivity, increased errors, and presenteeism (being present but not fully functioning due to illness).

Today, I’ll briefly explore a new nasal spray for those suffering from migraines.]

Background

Migraines can knock someone out of commission.

Symptoms such as nausea, pain, and light sensitivity can render it impossible to work or care for family members.

Migraine is the leading cause of disability among women.

Many people suffered migraines, including Julius Caesar, St. Paul, Thomas Jefferson, and Charles Darwin.

My friend is one of many searching for better migraine management options.

First, I cannot resist looking at the historical record.

A Brief History of Migraines

The ancient Egyptians described migraines and nerve pain.

Hippocrates (460–370 BC), the father of medicine, was the first to document migraine scientifically.

“A bright light in the right eye, followed by the onset of severe pain in the head, which eventually extended to the entire area.”

Let’s turn to the breakthrough.

A Nasal Spray for Migraines: Timolol

There are many migraine medications, but they sometimes are not very effective, have high costs, or associated side effects.

Migliazzo and Hagan published the first case series of long-term success in treating acute migraines with timolol eye drops.

Timolol eye drops bypass the digestive process when applied to healthy eyes.

They rapidly travel through the tear ducts to the nasal passages, where absorption by the nasal mucosa rivals the speed of intravenous injection.

A nasal spray makes sense since the mechanism of action is through the nose (and some have trouble using eye drops).

Nasal Spray Study

Researchers had a national compounding pharmacy create a nasal spray device to deliver Timolol.

Patients spray each nostril quickly at the first onset of headache.

If symptoms persist, they can repeat the spar 10 to 15 minutes later, with a maximum number of sprays found in 24 hours.

No one on beta-blocker medicines was offered the spray.

Nasal Spray Results

Here are the results of a small series of 16 patients with refractory migraines:

Ten patients (63 percent) reported being pleased with the nasal Timolol and added it to their preferred treatment.

There were no significant side effects.

My Take

A National Headache Foundation survey indicates that the majority of individuals with migraine are unable to control their disease and are dissatisfied with current preventive treatment options.

We must do better.

The reported series on nasal timolol is remarkably small.

Concerning safety, Timolol has been approved for glaucoma, many cardiovascular conditions, and migraines for over 40 years, and it has a long track record of safety.

If you have acute migraine headaches that are not responding satisfactorily to standard medicines, nasal spray timolol 0.5% may offer you another option.

Finally, the study authors offer this:

“A huge advantage of this treatment is that it is presently available from O’Brien Pharmacy in Kansas City and Bayview Pharmacy in Rhode Island by prescription. The formulation has been published in the International Journal of Pharmacy Compounding, so other local compounding pharmacies should be able to prepare it.”

The study authors indicate they have no financial conflicts.