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I just started back on Topamax after being off the medication for 4 years. I suffer from cluster headaches, when a cluster starts the debilitating headaches come everyday. The last time I took Topamax it stopped the cluster within a week. I continued working up to the full dose and the side effects gradually decreased (confusion, hard to concentrate, difficulty with finding the words to express my thoughts). I found that a lower dose kept the headaches away so I dropped down for a few months then came off the drug completely. Last week a new cluster started so I am back on the Topamax and have had a couple of headache free days already. This medication works well for me at a lower dose and limits the side effects.
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