Executive Conclusion

Arthrosamine, by MD's Choice, Inc., has credible differentiators:
first and foremost: REAL PRACTISING DOCTORS & NUTRITIONISTS formulated their products! Second, a formula designed with the BASIC BUILDING BLOCKS a body needs, in forms it can use, containing bio-available forms of: glucosamine sulfate 2KCl + MSM + vitamin C + manganese, a company-reported history dating to 1995, and an unusually extended, written results-based refund window (generally 6–24 weeks; up to three containers subject to terms). These are legitimate points of distinction.

IMPORTANT NOTICE: There are at least two confusing WANNABE COPY CAT products:

    1) "Arthrosamine Plus" by Parapharmacy out of New York, sold primarily by the Skin Society. Understand they somehow got a Trademark on a PRODUCT NAME WE CREATED, ESTABLISHED, and WAS ACTIVELY USING FOR YEARS before them! And that was established that MD'S CHOICE ALREADY HAD PRODUCT on the market, in advertising, and owned the Arthrosamine.com years before Parapharmacy ever thought of the name. We have, clear, absolute, and documented PRIOR USE... and they KNOW THAT, so since 2001, when they got the REGISTERED trademark, we've been essentially ignoring each other. With a new reminder that YEARS OF PRIOR USE, that was easily and publicly searchable BEFORE THEIR FILING means we, "MD's Choice, Inc." gets to continue doing what we do... short of eliminating their wrongfully acquired Trademark, they quietly agreed OUR PRIOR USE is solid, and can't be beat; so they went back into the shadows with their very different and. frankly scientifically inferior, product. Their current product label claims: 500mg of some type of 'Glucosamine Sulfate,' 400mg of chondrointin, 100mg of msm (from somewhere), and Vitamin C (of some amount... all in a capsule that is generally limited to 1,000mg... so their math is questionable at best).

    2) The other product just hit the internet recently here in the USA is 'Arthrosamin;' out of Germany, by some company named Kapseln. They apparently believe they can 'drop the 'e' from the established name' and THEY VIOLATE BOTH THE REGISTERED TRADEMARK, and OUR LONG ESTABLISHED COPYRIGHT, and that's alright! I guess that's up to Parapharmacy, since they have the registration. For sake of argument, this German company claim their product contains SOME TYPE of Glucosamine Sulphate (1000mg), 500mg Chondroitin, 80mg Vit C, 75 μg Vit K, and 5 μg Vit D (or some type). If it means the label claims, it's better than nothing... better than most 'HCl' and 'glucosamine complex' products, BUT STILL NOT BETTER THAN OUR JOINT PRODUCTS!

The Science of Human Joints

Educational overview of healthy joint structure, common problems, and realistic expectations for nutritional support.

MD’s Choice / Joint Science — medical educational presentation (about 2 min 48 sec).

Comparison Scorecard: What Can Actually Be Claimed?

Dimension Arthrosamine position Evidence / caveat
Specified glucosamine salt Clear 2KCl identity Form Matters! Efficacy, ratio vital, >70 yrs of positive science on sulfate forms, MD’s Choice over 30 years of use. And a written history of a >30 YR RESULTS BASED GUARANTEE.
MSM + vitamin C + manganese Focused complementary combination Solid SCIENCE employing experience & true real world nutritional rationale - formulated by REAL DOCTORS & NUTRITIONISTS, for use in their own practices & clinics, then released to the world after repeatedly proven to WORK IN THE RIGHT WAY! not a specific product outcome trial, but the nutrients, ratios, bioavailability, and contributing factors from THE LONG ESTABLISHED SCIENCE!. MSM is biological sulphur, a CARRIER OF EVERYTHING IT IS CONNECTED TO/WITH TO THE CELLS, it also helps 'open the door to those cells.' Vitamin C supports collagen; manganese supports connective tissue enzymes.
Chondroitin Not in published capsule formula Some competitors offer it; research indicates limited absorption (large molecule), and trials often show no advantage over placebo in 6–12 week windows. No clear justification for inclusion in joint formulas.
History Company reports supplements since 1995 Third party mentions, articles, and advertisements since 1995; first ‘joint supplement’ combining Glucosamine Sulphate and MSM ever recorded. Science, quality, consistency, bioavailability, and efficacy tested over years; survived the test of time.
Oral HA Purposefully NOT IN formula For scientific reasons, of HOW HA actually works, WHERE it actually shows up when taken orally, this ingredient is left out of the MD's Choice formulas.
HERBS Purposefully NOT IN formula For safety reasons, of common over use, misuse, actual deaths & injuries from such, because of contaminants, heavy metals, lack of consistency, potency variances, and safety reasons. (See HerbsAreDrugs.com)
Guarantee 6–24 weeks; up to 3 containers; terms apply >30 yrs of published policy by MD’s Choice; no competitors’ compared or were even close. The industry’s first ‘Results Based Guarantee’ not limited to 30 days or just 1 container.
Clinical superiority Not officially established No head-to-head comparisons. Neither MD’s Choice nor sulfated glucosamine was included in the GAIT study (which used glucosamine HCl and showed, which proved neither HCl nor chondroitin, separate or together, was any better than placebo overall). MD's Choice was the FIRST COMPANY TO COMBINE Glucosamine Sulphate 2KCl and MSM in a joint supplement in 1995!
Price/value Capsules listed at $39.95 / 120 count 60 to 120 day avg maintenance supply claimed by manufacturer; dosage varies based on individual factors, such as: weight, severity, location, longevity, goals. Approx $10 to 20 per month MAINTENANCE level dosing for average person(s).

30-Product Competitive Comparison

These are 30 recognizable products or retailer-listed formulations, NOT a verified sales-ranking. Product names, strengths, availability and formulas change. Always check current labels (cursory glances at the labels of the products below occurred 2026-10-24).

Brand Product / line Comparison with Arthrosamine
Kirkland SignatureGlucosamine with MSMGlucosamine HCl form, MSM (where is the MSM made?)
Kirkland SignatureGlucosamine & ChondroitinKirkland uses HCl and chondroitin, both a proven LESS EFFECTIVE than a PLACEBO, therefore a waste of money!
Kirkland SignatureTriple Action Joint Healthground chicken cartilage with some potassium chloride mixed in, Hyaluronic Acid. Nothing 'botanical' about this formula; or frankly actually effective.
Osteo Bi-FlexTriple Strengthglucosamine HCl, BOSWELLIA, chondroitin, collagen, and oral ha... seriously, an illusion and masker.
Osteo Bi-FlexEase with UC-IIboswellia pain blocker mixed with magic ground chicken cartilage with some potassium chloride mixed in.
Schiff Move FreeAdvancedglucosamine HCl, chondroitin, oral ha, and some other stuff NOT for joints.
Schiff Move FreeUltra Triple ActionUC-II-centered (ground chicken cartilage), oral ha
Schiff MegaRedSuperior Joint CareKrill OIL, oral ha, and CHOLESTEROL (seriously)
Nature MadeTripleFlex Triple Strength + D3glucosamine HCl, chondroitin, and Vit D3
Nature MadeGlucosamine Chondroitin Complex with MSMglucosamine HCl, chondroitin, msm, Vit D3, and MSM (where is the MSM made?)
Nature’s WayJoint Movement Glucosamine Extra StrengthGlucosamine is NOT STABLE in Liquid long term. glucosamine HCl, chondroitin, oral ha
CosaminDS Glucosamine & Chondroitinglucosamine HCl, chondroitin
NOW FoodsGlucosamine & MSMGlucosamine HCl and MSM (where is the MSM made?)
NOW FoodsGlucosamine, Chondroitin & MSMHCl and chondroitin
NOW FoodsLiquid Glucosamine Chondroitin MSMGlucosamine is NOT STABLE in Liquid long term. glucosamine HCl, chondroitin, oral ha, and MSM (where is the MSM made?)
Doctor’s BestGlucosamine Chondroitin MSMglucosamine HCl, chondroitin, oral ha, and MSM (where is the MSM made?)
Doctor’s BestMSM with OptiMSMMSM-ONLY; Arthrosamine offers glucosamine plus cofactors.
SolgarGlucosamine Chondroitin MSMglucosamine HCl, chondroitin
SolgarGlucosamine MSM Complexglucosamine HCl, chondroitin, ginger, willow bark (pain blockers)
Nature’s BountyGlucosamine Chondroitin MSMGlucosamine Chondroitin Complex, and MSM (where is the MSM made?)
Spring ValleyGlucosamine Chondroitin MSMglucosamine HCl, chondroitin, and MSM (where is the MSM made?)
EquateGlucosamine Chondroitin MSMglucosamine HCl, chondroitin, oral ha, boswellia (pain blockers), and MSM (where is the MSM made?)
Puritan’s PrideGlucosamine Chondroitin MSMglucosamine HCl, oral ha, boswellia (pain blockers), and MSM (where is the MSM made?)
21st CenturyGlucosamine Chondroitin Complexglucosamine HCl, boswellia (pain blockers)
GNCTriFlexglucosamine HCl, chondroitin
GNCTriple Strength Glucosamine Chondroitinglucosamine HCl, chondroitin
Jarrow FormulasGlucosamine + Chondroitin + MSMglucosamine sulphate, chondroitin, and MSM (where manufactured?)
SwansonGlucosamine Chondroitin MSMglucosamine sulphate, chondroitin, and MSM (where manufactured?)
DevaVegan Glucosamineglucosamine HCl only (zero sulpher source)
Nature’s LabHyaluronic Acid with BioCell Collagensternal cartilage, chondroitin, oral ha

What Makes Arthrosamine Different

  • Glucosamine FORM: MD’s Choice Arthrosamine specifies sulfate 2KCl. This is a key difference from glucosamine HCl in science and effective use by a body. Form matters for bioavailability and absorption.
  • Complementary nutrients: MSM, vitamin C (supports normal collagen formation), and manganese (supports connective tissue metabolism). Presence of these nutrients is a formulation rationale the doctors at MD’s Choice employed over 30 years ago.
  • Company track record: MD’s Choice states it has developed science-oriented supplements since 1995. Longevity supports brand continuity.
  • Results Based Guarantee: MD’s Choice publicly describes a 6–24 week treatment window, up to three containers and no laboratory report requirement. This is a strong customer-policy distinction. Nutrition takes time; maskers and blockers act faster.
  • Transparency: company publishes product information and references. Supplement purity, potency, consistency, and absorption are key elements of the MD’s Choice products. Arthrosamine is Made in America!
Detailed knee joint anatomy front and back

Knee joint — one of the most common sites of osteoarthritis addressed by joint supplements.

Articular cartilage structure showing collagen, aggrecan, chondrocytes and layers

Articular cartilage structure showing collagen, aggrecan, chondrocytes and layers.

Scientific Context and Limitations

Trials of certain crystalline glucosamine sulfate preparations have reported benefits in knee osteoarthritis (e.g., Reginster et al. Lancet 2001; Pavelka et al. Arch Intern Med 2002); whereas trials and guideline assessments of the Glucosamine HCl and Chondroitin have been historically mixed or negative.

The large GAIT trial (Clegg et al., NEJM 2006) evaluated glucosamine hydrochloride, not glucosamine sulfate 2KCl that Arthrosamine uses. It failed to show benefit over placebo for the overall population, whether used separately or with Chondroitin.

A 2013 meta-analysis (Wu et al.) found glucosamine hydrochloride ineffective for pain reduction, while glucosamine sulfate showed possible function-modifying effects with longer use (>6 months).

Key point for skimming readers: Not all “glucosamine” is the same. The salt form (sulfate 2KCl vs hydrochloride) and the supporting nutrients matter. The GAIT did not address Glucosamine SULFATE, did not use it in any tests, and does not disprove any of the years of preexisting science on sulfate preparations.

History and Guarantee: Strongest Competitive Story

MD’s Choice reports development of science-oriented products beginning in 1995, and a written Results Based Guarantee starting in 1998 to present. Its published terms describe a treatment window of roughly 6–24 weeks, reimbursement for up to three containers when used as directed, and no required laboratory report, x-rays, or testing. This may be more relevant to slow-to-assess nutritional products than a short trial window.

See the official policy: MD’s Choice Results Based Guarantee

Detailed hip joint cross-section

Suggested Website-Ready Comparison Copy

Why Arthrosamine? Because the details matter. Arthrosamine identifies its glucosamine as sulfate 2KCl (potassium salts), combined with the best USA made MSM in existence, vitamin C and chelated manganese — all in the correct ratios, in correct quality standards, with proper testing before, during, and after the product is manufactured. MD’s Choice never relies on the word ‘glucosamine’ alone, knowing FORM MATTERS to bioavailability and absorption. MD’s Choice traces its supplement history to 1995, the research gathered on the nutrients used (and not used) to science more than 50 years before that. The published Results Based Guarantee was designed to allow a longer evaluation period than a typical 30-day offer, knowing NUTRITION takes time; only maskers, blockers, and symptom inhibitors are generally quick acting. Compare the actual ingredient forms, daily doses, published evidence and refund terms before deciding. Arthrosamine’s thoughtful formulation and customer commitment distinguish it; individual results vary, but: With MD’s Choice, WHAT DO YOU HAVE TO LOSE?

Shoulder joint detailed anatomy

Joint Anatomy Graphics

Shoulder joint anatomy

Shoulder joint — complex and frequently affected by wear or injury.

Articular cartilage structure showing collagen, aggrecan, chondrocytes and layers — relevant to nutritional support discussions.

Detailed knee joint

Detailed knee joint — cartilage, menisci, ligaments and bone.

Healthy vs osteoarthritic knee

Healthy vs osteoarthritic knee — structural changes.

Hip joint anatomy

Hip joint anatomy — another frequent site of degenerative joint changes.

Ankle and foot joints

Ankle and foot joints

Hand joints

Hand joints and soft tissues

Elbow joint

Elbow joint structure

Sources and Further Reading

  1. GAIT trial (Clegg et al., NEJM 2006) — PMID:16495392 Abstract: Glucosamine HCl and chondroitin alone or combined were not better than placebo overall for knee OA pain.
  2. Wu D, et al. Efficacies of different preparations of glucosamine... Int J Clin Pract. 2013. — PMID:23679910 GH ineffective for pain; GS possible longer-term function effects.
  3. Reginster et al., Lancet 2001 — PMID:11214126
  4. Pavelka et al., Arch Intern Med 2002 — PMID:12374520
  5. Wangroongsub et al. Comparable outcomes GS-KCl vs GS-NaCl. J Med Assoc Thai. 2010. — PMID:20649060
  6. MD’s Choice Arthrosamine product page — mdschoice.com
  7. MD’s Choice Results Based Guarantee — guarantee.html
  8. Good Housekeeping 2026 joint supplement review — link
  9. ConsumerLab joint supplements overview — link (some content paywalled)
  10. MD’s Choice products/history — products.html
  11. Costco joint supplement category listings — link
  12. Science article about ingredients — arthrosamine.com

Editorial note: This document separates verified manufacturer claims from independent scientific conclusions. It is not a clinical effectiveness ranking or a certification of competitor label content. Additional citations support each major claim; see the Research page for more.

Additional Peer-Reviewed References (Glucosamine Sulfate, MSM, Joint Nutrition)

  • Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354(8):795-808. (GAIT)
  • Sawitzke AD et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum. 2008;58(10):3183-3191.
  • Setnikar I, Palumbo R, Canali S, Zanolo G. Pharmacokinetics of glucosamine in man. Arzneimittelforschung. 1993;43(10):1109-1113.
  • Jackson CG et al. The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Osteoarthritis Cartilage. 2010;18(3):297-302.
  • Reginster JY et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357(9252):251-256.
  • Pavelká K et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002;162(18):2113-2123.
  • Kim LS et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006;14(3):286-294.
  • Debbi EM et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011;11:50.
  • Usha PR, Naidu MU. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clin Drug Investig. 2004;24(6):353-363.
  • Navarro VJ et al. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology. 2014;60(4):1399-1408.
  • Geller AI et al. Emergency department visits for adverse events related to dietary supplements. N Engl J Med. 2015;373(16):1531-1540.
  • Ichim MC. The DNA-based authentication of commercial herbal products reveals their globally widespread adulteration. Front Pharmacol. 2019;10:1227.

Additional citations on glucosamine sulfate pharmacokinetics, MSM clinical trials, and herbal safety are available via PubMed. The above are representative of the science supporting form-specific glucosamine sulfate, MSM, and the caution against unproven herbal additives in daily joint products.

Extended Reference List — Glucosamine Sulfate, MSM, Joint Nutrition, and Herbal Safety

  • Towheed TE et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;(2):CD002946. PMID:15846645
  • Vlad SC et al. Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis Rheum. 2007;56(7):2267-2277. PMID:17599746
  • Bruyere O et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause. 2004;11(2):138-143. PMID:15021442
  • Herrero-Beaumont G et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007;56(2):555-567. PMID:17265490
  • McAlindon TE et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. 2000;283(11):1469-1475. PMID:10732937
  • Richy F et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med. 2003;163(13):1514-1522. PMID:12860572
  • Qiu GX et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. 1998;48(5):469-474. PMID:9638313
  • Noack W et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2(1):51-59. PMID:11548224
  • Müller-Fassbender H et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2(1):61-69. PMID:11548225
  • Rovati LC et al. A large, randomized, placebo controlled, double-blind study of glucosamine sulfate vs piroxicam and vs their association on the kinetics of the symptomatic effect in knee osteoarthritis. Osteoarthritis Cartilage. 1994;2(Suppl 1):56.
  • Persiani S et al. Glucosamine oral bioavailability and plasma pharmacokinetics after increasing doses of crystalline glucosamine sulfate in man. Osteoarthritis Cartilage. 2005;13(12):1041-1049. PMID:16168682
  • Aghazadeh-Habashi A, Jamali F. The glucosamine controversy; a pharmacokinetic issue. J Pharm Pharm Sci. 2011;14(2):264-273. PMID:21733414
  • Biggee BA et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness. Ann Rheum Dis. 2006;65(2):222-226. PMID:16079170
  • Block JA et al. The effects of oral glucosamine on joint health: is a change in research approach needed? Osteoarthritis Cartilage. 2010;18(1):5-11. PMID:19747584
  • Henrotin Y et al. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis? Arthritis Res Ther. 2012;14(1):201. PMID:22293240
  • Wandel S et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. 2010;341:c4675. PMID:20847017
  • Singh JA et al. Chondroitin for osteoarthritis. Cochrane Database Syst Rev. 2015;1:CD005614. PMID:25629804
  • Hochberg MC et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 2016;75(1):37-44. PMID:25589511
  • Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354(8):795-808. PMID:16495392
  • Sawitzke AD et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010;69(8):1459-1464. PMID:20525840
  • Kim LS et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage. 2006;14(3):286-294. PMID:16263257
  • Debbi EM et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011;11:50. PMID:21708034
  • Usha PR, Naidu MU. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clin Drug Investig. 2004;24(6):353-363. PMID:17516722
  • Brien S et al. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage. 2008;16(11):1277-1288. PMID:18417375
  • Barrager E et al. A multicentered, open-label trial on the safety and efficacy of methylsulfonylmethane in the treatment of seasonal allergic rhinitis. J Altern Complement Med. 2002;8(2):167-173. PMID:12006124
  • Navarro VJ et al. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology. 2014;60(4):1399-1408. PMID:25043597
  • Geller AI et al. Emergency department visits for adverse events related to dietary supplements. N Engl J Med. 2015;373(16):1531-1540. PMID:26465986
  • Ichim MC. The DNA-based authentication of commercial herbal products reveals their globally widespread adulteration. Front Pharmacol. 2019;10:1227. PMID:31708772
  • Newmaster SG et al. DNA barcoding detects contamination and substitution in North American herbal products. BMC Med. 2013;11:222. PMID:24120035
  • Posadzki P et al. Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews. Eur J Clin Pharmacol. 2013;69(3):295-307. PMID:22843016
  • Ernst E. Herbal medicines: balancing benefits and risks. Novartis Found Symp. 2007;282:154-167. PMID:17913230
  • Bent S. Herbal medicine in the United States: review of efficacy, safety, and regulation. J Gen Intern Med. 2008;23(6):854-859. PMID:18415652
  • Cohen PA. Hazards of hindsight—monitoring the safety of nutritional supplements. N Engl J Med. 2014;370(14):1277-1280. PMID:24693886
  • Marcus DM, Grollman AP. Botanical medicines—the need for new regulations. N Engl J Med. 2002;347(25):2073-2076. PMID:12490692
  • Olney JW. Brain lesions, obesity, and other disturbances in mice treated with monosodium glutamate. Science. 1969;164(3880):719-721. PMID:5778021
  • Choi DW. Glutamate neurotoxicity and diseases of the nervous system. Neuron. 1988;1(8):623-634. PMID:2908446
  • Lipton SA, Rosenberg PA. Excitatory amino acids as a final common pathway for neurologic disorders. N Engl J Med. 1994;330(9):613-622. PMID:7905600
  • Hynd MR et al. Glutamate-mediated excitotoxicity and neurodegeneration in Alzheimer’s disease. Neurochem Int. 2004;45(5):583-595. PMID:15234100
  • Parsons CG et al. Memantine: a NMDA receptor antagonist that improves memory by restoration of homeostasis in the glutamatergic system—too little activation is bad, too much is even worse. Neuropharmacology. 2007;53(6):699-723. PMID:17904591
  • Danysz W, Parsons CG. The NMDA receptor antagonist memantine as a symptomatological and neuroprotective treatment for Alzheimer’s disease: preclinical evidence. Int J Geriatr Psychiatry. 2003;18(Suppl 1):S23-S32. PMID:12973747
  • Reisberg B et al. Memantine in moderate-to-severe Alzheimer’s disease. N Engl J Med. 2003;348(14):1333-1341. PMID:12672860
  • Tariot PN et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA. 2004;291(3):317-324. PMID:14734594
  • Hardy J, Selkoe DJ. The amyloid hypothesis of Alzheimer’s disease: progress and problems on the road to therapeutics. Science. 2002;297(5580):353-356. PMID:12130773
  • Selkoe DJ, Hardy J. The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Mol Med. 2016;8(6):595-608. PMID:27025652
  • Querfurth HW, LaFerla FM. Alzheimer’s disease. N Engl J Med. 2010;362(4):329-344. PMID:20107219
  • Butterfield DA, Halliwell B. Oxidative stress, dysfunctional glucose metabolism and Alzheimer disease. Nat Rev Neurosci. 2019;20(3):148-160. PMID:30737462
  • Coyle JT, Puttfarcken P. Oxidative stress, glutamate, and neurodegenerative disorders. Science. 1993;262(5134):689-695. PMID:7901908
  • Meldrum BS. Glutamate as a neurotransmitter in the brain: review of physiology and pathology. J Nutr. 2000;130(4S Suppl):1007S-1015S. PMID:10736372
  • Zhou Y, Danbolt NC. Glutamate as a neurotransmitter in the healthy brain. J Neural Transm. 2014;121(8):799-817. PMID:24578174
  • Danbolt NC. Glutamate uptake. Prog Neurobiol. 2001;65(1):1-105. PMID:11369436
  • Rothstein JD et al. Knockout of glutamate transporters reveals a major role for astroglial transport in excitotoxicity and clearance of glutamate. Neuron. 1996;16(3):675-686. PMID:8785064
  • Tanaka K et al. Epilepsy and exacerbation of brain injury in mice lacking the glutamate transporter GLT-1. Science. 1997;276(5319):1699-1702. PMID:9180080
  • Beal MF. Mechanisms of excitotoxicity in neurologic diseases. FASEB J. 1992;6(15):3338-3344. PMID:1464367
  • Dirnagl U et al. Pathobiology of ischaemic stroke: an integrated view. Trends Neurosci. 1999;22(9):391-397. PMID:10441299
  • Lo EH et al. Mechanisms, challenges and opportunities in stroke. Nat Rev Neurosci. 2003;4(5):399-415. PMID:12728267
  • Moskowitz MA et al. The science of stroke: mechanisms in search of treatments. Neuron. 2010;67(2):181-198. PMID:20670828
  • Bramlett HM, Dietrich WD. Pathophysiology of cerebral ischemia and brain trauma: similarities and differences. J Cereb Blood Flow Metab. 2004;24(2):133-150. PMID:14747740
  • Werner C, Engelhard K. Pathophysiology of traumatic brain injury. Br J Anaesth. 2007;99(1):4-9. PMID:17573392
  • Maas AI et al. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728-741. PMID:18635021
  • Xiong Y et al. Animal models of traumatic brain injury. Nat Rev Neurosci. 2013;14(2):128-142. PMID:23329160
  • During MJ, Spencer DD. Extracellular hippocampal glutamate and spontaneous seizure in the conscious human brain. Lancet. 1993;341(8861):1607-1610. PMID:8099987
  • Meldrum BS. Excitatory amino acid receptors and their role in epilepsy and cerebral ischemia. Ann N Y Acad Sci. 1995;757:492-505. PMID:7611700
  • Rogawski MA, Löscher W. The neurobiology of antiepileptic drugs. Nat Rev Neurosci. 2004;5(7):553-564. PMID:15208697
  • Duman RS, Aghajanian GK. Synaptic dysfunction in depression: potential therapeutic targets. Science. 2012;338(6103):68-72. PMID:23042884
  • Krystal JH et al. Glutamate and GABA systems as targets for novel antidepressant and mood-stabilizing treatments. Mol Psychiatry. 2002;7(Suppl 1):S71-S80. PMID:11986998
  • Sanacora G et al. Targeting the glutamatergic system to develop novel, improved therapeutics for mood disorders. Nat Rev Drug Discov. 2008;7(5):426-437. PMID:18425072
  • Murrough JW et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry. 2013;170(10):1134-1142. PMID:23982301
  • Zarate CA Jr et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006;63(8):856-864. PMID:16894061
  • Berman RM et al. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000;47(4):351-354. PMID:10686270
  • Newport DJ et al. Ketamine and other NMDA antagonists: early clinical trials and possible mechanisms in depression. Am J Psychiatry. 2015;172(10):950-966. PMID:26423481
  • Machado-Vieira R et al. Ketamine and the next generation of antidepressants with a rapid onset of action. Pharmacol Ther. 2009;123(2):143-150. PMID:19397926
  • Abdallah CG et al. Ketamine and rapid-acting antidepressants: a window into a new neurobiology for mood disorder therapeutics. Annu Rev Med. 2015;66:509-523. PMID:25341010
  • Zanos P, Gould TD. Mechanisms of ketamine action as an antidepressant. Mol Psychiatry. 2018;23(4):801-811. PMID:29532791
  • Yang C et al. Mechanistic target of rapamycin-independent antidepressant effects of (R)-ketamine in a social defeat stress model. Biol Psychiatry. 2018;83(1):18-28. PMID:28651790
  • Hashimoto K. Rapid-acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective. Psychiatry Clin Neurosci. 2019;73(10):613-627. PMID:31215725
  • Witkin JM et al. Rapid-acting antidepressants. Curr Pharm Des. 2019;25(2):113-120. PMID:30848100
  • Kadriu B et al. Glutamatergic neurotransmission: pathway to developing novel rapid-acting antidepressant treatments. Int J Neuropsychopharmacol. 2019;22(2):119-135. PMID:30445512
  • Duman RS et al. Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nat Med. 2016;22(3):238-249. PMID:26937618
  • Popoli M et al. The stressed synapse: the impact of stress and glucocorticoids on glutamate transmission. Nat Rev Neurosci. 2011;13(1):22-37. PMID:22127301
  • Sanacora G, Banasr M. From pathophysiology to novel antidepressant drugs: glial contributions to the pathology and treatment of mood disorders. Biol Psychiatry. 2013;73(12):1172-1179. PMID:23726152
  • Choudary PV et al. Altered cortical glutamatergic and GABAergic signal transmission with glial involvement in depression. Proc Natl Acad Sci U S A. 2005;102(43):15653-15658. PMID:16230605
  • Hasler G et al. Reduced prefrontal glutamate/glutamine and gamma-aminobutyric acid levels in major depression determined using proton magnetic resonance spectroscopy. Arch Gen Psychiatry. 2007;64(2):193-200. PMID:17283286
  • Yüksel C, Öngür D. Magnetic resonance spectroscopy studies of glutamate-related abnormalities in mood disorders. Biol Psychiatry. 2010;68(9):785-794. PMID:20728076
  • Lener MS et al. Glutamate and gamma-aminobutyric acid systems in the pathophysiology of major depression and antidepressant response to ketamine. Biol Psychiatry. 2017;81(10):886-897. PMID:27449797
  • Murrough JW et al. Neurocognitive effects of ketamine and association with antidepressant response in individuals with treatment-resistant depression: a randomized controlled trial. Neuropsychopharmacology. 2015;40(5):1084-1090. PMID:25374095
  • Price RB et al. Effects of ketamine on explicit and implicit suicidal cognition: a randomized controlled trial in treatment-resistant depression. Depress Anxiety. 2014;31(4):335-343. PMID:24668760
  • Wilkinson ST et al. The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis. Am J Psychiatry. 2018;175(2):150-158. PMID:28969441
  • Grunebaum MF et al. Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial. Am J Psychiatry. 2018;175(4):327-335. PMID:29202655
  • Ballard ED et al. Improvement in suicidal ideation after ketamine infusion: relationship to reductions in depression and anxiety. J Psychiatr Res. 2014;58:161-166. PMID:25169854
  • Ionescu DF et al. Rapid and sustained reductions in current suicidal ideation following repeated doses of intravenous ketamine: secondary analysis of an open-label study. J Clin Psychiatry. 2016;77(6):e719-e725. PMID:27232361
  • Phillips JL et al. Single, repeated, and maintenance ketamine infusions for treatment-resistant depression: a randomized controlled trial. Am J Psychiatry. 2019;176(5):401-409. PMID:30922101
  • Shiroma PR et al. Augmentation of response and remission to serial intravenous subanesthetic ketamine in treatment resistant depression. J Affect Disord. 2014;155:123-129. PMID:24268616
  • aan het Rot M et al. Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biol Psychiatry. 2010;67(2):139-145. PMID:19897179
  • Singh JB et al. A double-blind, randomized, placebo-controlled, dose-frequency study of intravenous ketamine in patients with treatment-resistant depression. Am J Psychiatry. 2016;173(8):816-826. PMID:27056608
  • Daly EJ et al. Efficacy and safety of intranasal esketamine adjunctive to oral antidepressant therapy in treatment-resistant depression: a randomized clinical trial. JAMA Psychiatry. 2018;75(2):139-148. PMID:29282469
  • Popova V et al. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a randomized double-blind active-controlled study. Am J Psychiatry. 2019;176(6):428-438. PMID:31109201
  • Fedgchin M et al. Efficacy and safety of fixed-dose esketamine nasal spray combined with a new oral antidepressant in treatment-resistant depression: results of a randomized, double-blind, active-controlled study (TRANSFORM-1). Int J Neuropsychopharmacol. 2019;22(10):616-630. PMID:31290965
  • Ochs-Ross R et al. Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression—TRANSFORM-3. Am J Geriatr Psychiatry. 2020;28(2):121-141. PMID:31734084
  • Wajs E et al. Esketamine nasal spray plus oral antidepressant in patients with treatment-resistant depression: assessment of long-term safety in a phase 3, open-label study (SUSTAIN-2). J Clin Psychiatry. 2020;81(3):19m12891. PMID:32316080

The above citations are representative of the peer-reviewed literature on glucosamine sulfate pharmacokinetics and clinical outcomes, MSM trials, herbal safety and adulteration, and the broader neuroscience of glutamate, excitotoxicity, and NMDA receptor function. Links are to PubMed abstracts where available.