Question about Methotrexate...?

Question

I have undifferentiated mixed connective tissue disease. I've tested positive for Sjogren's syndrome a few years back, but it is not primary. That means that I either have Lupus or Rheumatoid Arthritis. I've been taking plaquenil for 4+ years and had some toxicity. My dose has been decreased and I started taking Methotrexate in August. I currently take 10 mg. I've noticed minimal (very, very minor) improvement in joint swelling. I seem to have 2-3 good days a week, but still have considerable swelling in my joints. I see my rheumatologist in 3 weeks, but I thought I would ask anyone who is taking methotrexate to see how long it took them to know it is working.
My major complaint is fatigue. I'm exhausted and I don't think the fatigue is worth the minimal improvement. If anyone who is currently taking this med can give me some advice, I would greatly appreciate it. Should I hang in there? I'm also doing homeopathic treatments with a doc and aqua therapy 2-3x a week.

Answer 1

I have systemic lupus. I have not taken methotrexate, but I did receive it intravenously in the hospital along with pulse steroids. I had bone marrow failure from the lupus and a very high sed rate, including pericarditis and other things. I too take plaquenil. I have been off prednisone for 6 months. I still take mycophenolate mofetil-Cellcept-for lupus kidney disease. It is hard to know whether it is the medication or the disease making you tired. Autoimmune mixed connective tissue diseases are extremely trick to manage. I would hang in there until you see your rheumy. Keep a journal of your activities and your symptoms. You may see some connections and this journal will be very useful to your rheumatologist. Please be sure to tell all your doctors and practitioners what the others are doing. If you have a good working relationship with your rheumatologist, you should be able to talk about your homeopathic and other complementary treatments with him or her. If you cannot talk this openly, get another doctor. The stress of the disease and its management are enough to bring on fatigue. Add to that the fact that the disease ITSELF causes fatigue and it is no wonder you feel that way. You did not get to your current level of inflammation overnight and it will not go down overnight. Are you on prednisone too? Did you have chloroquine retinopathy from the plaquenil? Feel free to email me at [e-mail]

Best wishes. Be patient.

Answer 2

I have had RA for 8 years and have been on Methotrexate for all 8 years. I previously also took plaquenil but was told by my rheumatologist that the side effects were not worth the small benefit. With methotrexate you must be careful about mouth ulcers, therefore be sure to take folic acid as well to deter this side effect. Methotrexate does minimize the pain and aches but not as effectively or consistently as either Enbrel, Remicade or Humira.
I have been using Enbrel with the methotrexate now for a year and notice an significant improvement, however none of these will help with the exteme fatigue. There are other meds that can help with the fatigue, you just have to be the "squeaky wheel" and don't give up. I would suggest asking about one of the other three meds I mentioned (however they are all pretty expensive so check with your health insurance first). Hope this helps.