RA- which meds work best/ anxious especially at night

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hey everyone. Chris here, 25 yr old male in the Chicago area, US. i have had (known) about RA for about 3 years now and methotrexate and folic acid are not helpful. my joints are down on inflamation but the mental side effects are extreme and flare up durations range from 2-7 weeks with maybe 2-3 days of being ok within that time frame. For example, hot flashes, negativity, depression, and most of all anxiety. currently even tho I have a new / non temp job and told I am doing great and was given my preffered shift, I still start dreading going in around dinner time or so each night. especially sundays. ( yes, no one likely enjoys going to work, and we all complain, however for me this is a whole new level that 1 is not healthy (loss of sleep, worry) and 2 I am not myself). the RA dr i have is not the best, i am looking to leave them for various reasons including the continued push that I am fine in terms of no joint pain when the md examines me and pushes aside my other concerns as RA flare up is only joint pain to them and im using the wrong wording nor can the md desire to help. also, my immue system goes down heavily when on metho trexate. and i have chronic sinus infections, and that combined with ra makes my quality of life miserable and long lasting. Noted I have seen this md for 3 years and just a few weeks ago did the md say " oh when your sick like this, you can stop methotrexate to boost immune system" and i (as in the md) have been sick for 3 weeks before, it happens) vs comprehending 7 weeks of issues as if it is nothing. i am curious to see what specialty meds such as enbrel humira and xeljans work and what is most effective in terms of joint pain and limiting the mental side effects i. mentioned. from my regular md, he provides me lorazepam and escitalpram forcsleep and anxiety which sometimes helps. sometimes no. please help

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  • Posted

    Sorry you are so down. Been there myself its rotten there at moment waiting to start new meds But talk to dr tell him exactly how you feel can you get the new anti tnf s they can be imazine . Also its not great when immune system is so low have you got good family and friends just dont let it beat you you will have goid patches

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  • Posted

    Nice to hear from you chifan90 I'm in England and have a marvellous rhumatoligists but I never go to doctors. I've had severe ra in all my joints for 15 years and in the beginning I had steroid shots which were marvellous. 

    Then I read about the side effects and that of all the other drugs and I kept well away. I managed over the years with ibuprofen ( antinflammatory ) parcetamol and a special diet which I can't promote on this forum. On the whole I'm great though I have had my ups and downs so a few months ago I read that 5 mg pred is not harmful with a tiny risk of side effects very long term so I rang my normal doc and said please give me predisilone. I started at 15 mg a within a couple of weeks I was on 5 mg. this dose keeps me stable I'll give it up sometime but for now life's good I'm upbeat.

    insomnia is terrible ive always had it and I'm addicted to benzodiazepines though I take zopiclone. I think sleepers cause insomnia and anxiety but we need then to sleep because of addiction. They make you think about insomnia and that the difference because good natural sleepers don't give in thought ie energy. Good luck. I wish I could suggest more on this forum.

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  • Posted

    I have been on methotrexate too. Didn't suit my kidneys but I didn't get anxiety or sleeplessness with it. Have you checked the side effects of the other drugs you are on? Or how they react in combination? You may need a lower does of Methotrexate if your immune system is so impaired. Its not good that they just got around to telling you to stop taking it if you get an infection. I'm concerned that you feel they are not listening to you. Its wise of you to look for another docotr. Its not just about controling RA but being able to live with the side effects of the drugs too and you are taking quite a cocktail of them! Time for a second opinion I think....
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  • Posted

    Are you by any chance also taking prednisolone?

    because this drug affects me in the way you describe as it s similar to what your adrenal gland produces.

    iIf not then in your position I think I would ask md for an alternative to methotrexate ( there are several) and also look carefully at my lifestyle- enough exercise/ rest/ / social support/ small goals. ? Also consider diet. I think the RA itself can cause depression and problems with sleep too so it's not always easy to find out causes.

     we all seem to react differently to different meds- so it s worth asking to try something else. It s a bit of a roller coaster finding meds that work for each individual so important to have a rheumy you feel listens to you.

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