The Evaluation of Topiramate as a First-Line Medication for Cluster Headache Prophylaxis: A Prospective Observational Cohort Study

In this observational cohort, topiramate monotherapy was associated with reductions in pain severity and headache-related disability and was generally well tolerated. These findings suggest that topiramate may be considered as a potential first-line or alternative prophylactic option in selected patients, particularly when treatment choices are limited or polypharmacy is undesirable.