Glucosamine for migraine prophylaxis?

Following a fortuitous observation that migraine headaches ceased in a pati ent receiving glucosamine therapy for osteoarthritis, a further ten patient s with migraine or migraine-like vascular headaches, refractory to establis hed preventive or abortive therapies, have been treated with daily oral glu cosamine. After a lag of 4-6 weeks, a substantial reduction in headache fre quency and/or intensity has been noted; in some cases, the benefit appears to be dose-dependent. Since glucosamine can be a rate-limiting precursor fo r mucopolysaccharide synthesis, it is germane to note previous reports that heparin and pentosan polysulfate may have migraine-preventive activity. Th ere is reason to suspect that mast cells are central mediators of the neuro genic inflammation associated with migraine and cluster headaches. The hepa rin produced by mast cells may function to provide feedback down-regulation of mast cell activation, and exerts a range of other anti-inflammatory eff ects. We postulate that supplemental glucosamine can boost mast cell hepari n synthesis - perhaps correcting a functional heparin deficiency - thereby preventing or ameliorating the neurogenic inflammation that mediates pain i n vascular headache. Whether or not this idea has validity, a controlled st udy of glucosamine for migraine prophylaxis appears to be warranted. (C) 20 00 Harcourt Publishers Ltd.