- © 2019 Marshfield Clinic
Neuropsychiatric Adverse Events from Topical Ophthalmic Timolol
- Nevio Cimolai, MD, FRCP(C)*,†
- *Department of Pathology and Laboratory Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- †Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Centre of British Columbia, Vancouver, British Columbia, Canada
- Corresponding Author: Nevio Cimolai MD, FRCP(C), Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, British Columbia, CANADA V6H3V4, Tel: (604) 271-9321 Fax: (604) 271-9321, Email: ncimolai{at}mail.ubc.ca
Abstract
Timolol is a commonly-used topical antiglaucoma medication and has proven to be highly efficacious for most recipients. Among the reported adverse events, the neuropsychiatric spectrum has been cited, albeit for a small proportion of those treated. This review summarizes the cumulative published experience of such side effects and assesses the quality of evidence. As for other beta-blockers, whether orally or topically administered, various central nervous systems dysfunctions have been detailed in either case reports or larger patient series. The adverse event commonly resolves following drug termination. Rigorous and more definitive studies of causation are lacking, and to some, such paucity has reduced the belief of a cause and effect relationship. Until otherwise proven, deference should be afforded to the potential for topical timolol to cause neuropsychiatric side effects, and at-risk patients should be closely monitored when they are prescribed this pharmacological agent.
