Methotrexate and Amitriptyline please share your experience
Posted , 6 users are following.
My Rhuemy is starting me on five 2.5mgs Methotrexate once a week and 25mgs Amitriptyline at bedtime. I am also to take a 1mg tablet of Folic acid once a day. All this for Arthritis I am feeling a liitle blue about this new addition to my regular meds. The info online about the MTX is pretty negative. Please share with me your experiences and advice concerning this type of therapy.I am grateful to have you ladies to turn to.
Thanks,
Sally
2 likes, 22 replies
mandy95 sally83545
Posted
My RA is also looking at starting me on Methotrexate I am quite concerned about this as I have loads of reactions to medications. I had to come off Hydroxychlorquinn do to reaction and problems that it caused with Muscle pain.
So any info would be helpful.
Regards,
Mandy
shira75032 sally83545
Posted
lily65668 shira75032
Posted
The one good thing about amitriptyline - as opposed to some of the modern anti-depressants - is that you can stop taking it whenever you like without it causing withdrawal symptoms. I stopped from one day to the next after a couple of months when I hadn't noticed any effects on the depression, only the physical side effects.
Give it a try. You can stop whenever you want so there's nothing to fear.
ashwani99192 lily65668
Posted
Thanks for the post.
I have one question.I am 39 years old male and having symptoms of Sjogern. Could you please tell me when it was diagnosed in your case and what test you were done when it was diagnosed.
How are you doing now?
I am very stressed out
Thanks for ur help
lily65668 ashwani99192
Posted
You're obviously one of the exceptions that prove the rule! Male and in your 30s, whereas it's more common in women and starts on average around age 50.
I started getting symptoms of Sjogren's around the age of 50, though I'd already had a severe attack of rheumatoid arthritis, lasting about six months, completely out of the blue in my mid-30s. The condition wasn't diagnosed for another ten years, however - though that's a very common story with Sjogren's sufferers. In my case it was diagnosed partly from symptoms, partly from blood tests - general inflammation markers plus anti-salivary gland antibiodies. Sjogren's is a syndrome - i.e. a whole collection of different signs and symptoms, with practically every individual having a different subset of symptoms rather than every single one. This means methods of diagnosis are variable. As far as I'm aware, biopsy of the salivary glands just under the lips, which I've never had, is the only cast-iron diagnostic tool, though it's my understanding that it's possible to have a normal lip biopsy and still get diagnosed with Sjogrens.
After 15 years of varied symptoms - dry mouth and eyes, peripheral neuropathy, carpal tunnel syndrome, Reynaud's syndrome, under-active thyroid etc. - I went into almost total remission around the age of 65. This lasted six years, until eight months ago when I had what narrowly missed being a very nasty accident, after which some of my old symptoms returned, together with a couple of new ones. I think this was due to a mixture of the physical effects of the accident and the shock. Now, however, things are just beginning to calm down again and I'm expecting to be more or less back in remission in a few months' time.
You should bear in mind that Sjogren's, like all auto-immune conditions, is very prone to flare-ups and remissions. Even if you're suffering badly right now, it doesn't automatically mean you'll be like this all your life.
ashwani99192 lily65668
Posted
Could you please in your case what was the actual story from beginning and what are you taking to relief the symptoms of dry eyes and dry mouth.I would really appreciate it
lily65668 ashwani99192
Posted
I'll try and re-construct the progress of my symptoms, though it all started more than 20 years ago now.
The dry mouth came first. I kept noticing a stale taste in my mouth and my lower lip sticking to my gums. But I've always been OK when actually eating, as long as I avoid things like dry bread or crackers. Then I developed deep, painful cracks at the corners of my mouth that kept splitting and bleeding when I opened my mouth to eat. This continued on and off for about a year. My GP told me it was allergy (which I knew it wasn't) and my dentist couldn't see anything wrong. I also got a raised, sore rash (probably fungal) on my upper lip during that time.
The mouth problems died down to manageable levels, only to be followed by peripheral neuropathy. Initially, altered sensation in one big toe, but spreading to all my extremities over the next ten years. This stopped abruptly (literally overnight!) ten years later, though it still occasionally comes back now. During the same period I started getting sore, sticky eyes, with frequent attacks of conjunctivitis. I got the same bleeding cracks at the corner of one eye as I'd had in my mouth. This eventually died down too, though still recurs from time to time, especially in the last few months.
In the next few years I suddenly started getting Reynaud's syndrome, for the first time in my life. One day my entire left hand went cold and white, even though it was a warm day. I also woke some days with my left hand fixed in a painful claw that I couldn't open till around midday. I saw various specialists - dentist, ophthalmologist, dermatologist, rheumatologist but they all said there was nothing wrong except mild inflammation. By this time I was starting to get very tired too, and was losing quite a lot of hair. My GP said it was all down to old age (I was about 55 at the time!) until the day I managed by pure chance to throw an impressive Reynaud's attack while actually in her office. That was when she ordered the blood test for anti-salivary gland antibiodies. She also sent me to an endocrinologist, who ordered a special urine test which diagnosed "covert hypothyroidism". My TSH had been sky-high for years, but as my T3 and T4 had always been at the low end of normal my GP had insisted I didn't have a thyroid problem.
I don't take any medications to relieve my symptoms, except for homeopathic remedies when I have an arthritis flare-up, and a mucolytic most nights. This is because I also have a tendency to very thick catarrh that clogs my air passages and causes sleep apnoea. I take bromhexine (Bisolvon), which I don't believe is available in the UK - if that's where you are. I use basic tear-replacement drops, though I sometimes used the more expensive ampoules when my eyes were very sore. These don't contain any preservatives, but neither kind is reimbursed by my medical insurance, so I use the ordinary kind as far as possible. During the period when I kept getting conjunctivitis, my GP prescribed chloramphenicol drops. Oh, and I take thyroxine for my under-active thyroid, but that's not strictly a medication. And that's it. Then again, my symptoms aren't very bad most of the time and can usually be managed by life-style measures. But there are plenty of people on this forum who will be able to advise you about meds.
ashwani99192 lily65668
Posted
It's good to hear that even you can live longer with this problem .
Symptoms you can manage With life
Style and certain medication.
My mouth get dry at times but it's not that bad as my lips touches the gum.
Thanks Aton.
lily65668 ashwani99192
Posted
Thank you for your sweet message. However, don't forget that my sufferings from Sjogrens have been minimal compared to many people on this site.
I hope you'll manage to co-exist with your symptoms too.
Lily
ashwani99192 lily65668
Posted
Have u ever tried using Restasis for dry eyes??
Could you able to produce saliva or not???
How is your dry mouth now??
Are you using humidifier in room ???
Did u do lip biopsy??
I think blood work also came positive??which test
Are you using preservatives free eye drops??
Thanks again
Thanks
Ashes j
lily65668 ashwani99192
Posted
Yes, I've always been able to produce enough saliva once I start eating, as long as I avoid extra-dry foods.
My mouth is not too bad at the moment. Nothing like the way it was 20 years ago at the outset. In fact it was never that bad again after the first year. Just at the moment I'm suffering a very dry mouth during the night, but I've learned that all my symptoms eventually go away if I don't put too much attention on them, so I don't do anything about it apart from keeping water handy.
No, I've never used a humidifier.
No - I've never had a lip biopsy, nor would I. Risk of nerve damage.
Haven't got the blood reports in front of me now. RF and CRP I recall, plus the anti-salivary gland antibodies. Not really too interested in my blood results anyway as I wouldn't consider medication unless the condition became totally disabling.
Yes, as already mentioned, I did use preservative-free eye drops during the really bad phase nearly 20 years ago but I manage just fine with the much cheaper normal drops now.
Good night!
Lily
sally83545
Posted
yes he is the one who diagnosed me. Most of my dryness is under control and that is the kind of side effect that I can deal with. It is mostly the MTX that has me concerned I would just like to know if the side effects are temporary and whether or not people think the drug has helped them.
thanks
Sally
suncat sally83545
Posted
need yo lok
do you have dry mouth will this help theesesmed
sally83545
Posted
Sally
lily65668 sally83545
Posted
I'm just wondering how painful and disabling your RA is at the moment, and also whether you've had it non-stop for years or whether it sometimes goes into remission. Clearly it's bad enough for it to be getting you down, or your rheumatologist wouldn't have put you on an antidepressant.
But you know, just because a doctor prescribes something for you, it doesn't mean you absolutely have to take it. Sometimes doctors feel pressured into prescribing draconian treatments because they feel a bit desperate when faced with a patient in severe pain.
I'm not saying you shouldn't take MTX, just suggesting that you think about whether you really need it.
sally83545 lily65668
Posted
he prescribed th Amitriptyline for better sleep ( the pain wakes me at night) and for the migrain headaches I end up with after a day of pain at the bases of my neck. I was tested for JRA when I was a kid and have had arthritic like flares all my life. I went to the doctor last week hoping for an injection of Cortizone (I had this before with a different doctor) because I can no longer close my right hand. My fingers on both hands are swollen and have nodules on the joints and no amount of NSAID has shown to improve my problem. My Doctor seemed a little stunned at how much inflamation I have developed. Cortizone is not enough to prevent joint damage and is only a temporary fix. So we are starting with MTX. I agree with him on this therapy especially if it will prevent damage I just feel a little blindsided by the diagnosis. (bummer). The pain is bad though and I have it in my knees ,balls of my feet and neck so I'm willing to give the MTX a shot...just wish I knew what to expect.
Thanks,
Sally
lily65668 sally83545
Posted
I hope you get some results from the new treatment.
Lily