Headaches in over 12s: diagnosis and management

Recommendation ID: CG150/3
Question: Topiramate to prevent recurrent cluster headache:- Is topiramate a clinically and cost effective prophylactic treatment for recurrent cluster headache?
Any explanatory notes (if applicable): Why this is important:- Cluster headache is an excruciatingly painful and highly disabling disorder. The management of cluster headache includes the use of preventive treatments to stop the attacks as quickly and safely as possible. There is a significant unmet clinical need for effective preventive treatments in cluster headache and few data to inform guidance on prophylaxis of cluster headache. Although numerous agents including verapamil, topiramate, lithium, methysergide and gabapentin are used in routine clinical practice, this is largely based on clinical experience as very few RCTs have been performed. Several open-label studies have reported on the efficacy of topiramate in the preventive treatment of cluster headache. There is therefore a need for a high-quality RCT of topiramate in the prevention of cluster headaches.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	02/10/2012