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A 2023 case series in Headache: The Journal of Head and Face Pain (Robbins et al.) reviewed 847 patients starting semaglutide and found: 14% reported headaches during the first 16 weeks Of those, 23% noted clear positional worsening (worse lying down or worse standing, depending on individual CSF dynamics) 89% of positional headaches resolved by week 20 without intervention beyond hydration 2.1% required temporary dose reduction 0.4% discontinued due to intolerable headache The positional component is underreported because patients don't always connect the pattern