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Hi Dan, Well you have the correct goal. Generally with cluster headache if you are not sure that a treatment is working- then it is NOT working. You are on a high dose of topiramate- did it ever work? How did you get up so high? If it is not helpful at 200mg a day then will not be at 600mg a day. Lucky for you tapering is easier with CH than with migraine. Suggest come down by 25mg-50mg a week. Not an exact science and you can cut the pills. Ideally with physician involvement we write scripts for 25mg tabs which makes tapering to zero easier. As you go lower you can take it all at night. Medically it is safe to taper quickly (over 2-3 weeks) but you have feel shitty. Me thinks your mind and memory will improve when you are off. Get off that stuff!! Peace