Acute Suicidal Depression Associated With Use of Timolol

To the Editor.— Timolol maleate (Timoptic), a topical β-blocking agent for lowering intraocular pressure, has gained widespread acceptance as a safe and effective drug. Since its introduction, various side effects have been reported, albeit at an acceptable incidence.¹Most of the systemic side effects described are common to all β-blockers and are presumably the result of absorption into the circulation. Uncommon but recognized side effects of this group include depression, paranoia, and psychosis.²Although mild CNS effects have been reported with timolol, including anxiety, disorientation, fatigue, and anorexia, major reactions have not been noted. A case of acute suicidal depression thought to be directly related to the use of timolol at normal dosage is described. Report of a Case.— A 65-year-old woman entered the E. S. Harkness Eye Institute, New York, with a hyphemia of 30% and an intraocular tension of 42. The patient suffered from adult-onset diabetes