Psychiatric side effects from topical ocular timolol, a beta-adrenergic blocker

Area of Science:

• Ophthalmology
• Psychiatry
• Pharmacology

Background:

• Systemic beta-blockers are known to cause neuropsychiatric side effects.
• Concerns exist regarding similar adverse reactions from topical ophthalmic medications.

Purpose of the Study:

• To investigate the occurrence of central nervous system (CNS) adverse events associated with topical ophthalmic timolol.
• To inform the psychiatric community about potential ocular drug-induced psychiatric conditions.

Main Methods:

• Analysis of data submitted to the National Registry of Drug-Induced Ocular Side Effects.
• Review of reported cases involving topical ophthalmic timolol administration.

Main Results:

• Out of 369 CNS cases, 163 (44%) reported neuropsychiatric effects.
• Reported effects included depression, psychosis, confusion, and hallucinations.
• Drug withdrawal typically led to symptom resolution within 1-7 days.

Conclusions:

• Topical ophthalmic timolol can induce significant neuropsychiatric side effects.
• Sudden mental status changes or new psychiatric conditions may be linked to ocular timolol use.
• Awareness and consideration of ocular timolol are crucial for diagnosing and managing psychiatric symptoms.