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July 1988

Topical β-Blocker Therapy and Central Nervous System Side Effects: A Preliminary Study Comparing Betaxolol and Timolol

Author Affiliations

From the Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas (Drs Lynch, Whitson, Brown, and Nguyen), and Alcon Laboratories, Fort Worth, Tex (Ms Drake). Drs Lynch and Brown are now with the Department of Ophthalmology, Emory University School of Medicine, Atlanta.

Arch Ophthalmol. 1988;106(7):908-911. doi:10.1001/archopht.1988.01060140054023

• Topical β-blocking agents have been associated with adverse central nervous system (CNS) effects, including depression, emotional lability, and sexual dysfunction. Two studies were done to determine if patients who develop CNS effects while using timolol maleate would improve with betaxolol hydrochloride. In one study, 18 patients with CNS symptoms during timolol therapy were switched to betaxolol. Sixteen of the 18 patients noted symptomatic improvement with betaxolol. The second study involved seven patients with CNS symptoms during timolol therapy who were entered into a double-masked cross-over study. In two patients CNS symptoms resolved with betaxolol; in three patients symptoms improved; and in one patient symptoms worsened with betaxolol. Although factors influencing β-blocker activity in the CNS are not well understood, there may be some advantage to a selective agent.

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