Methotrexate, sulfasalazine and alcohol

Hi Everyone,

I hope you’re all well.

In the last year I’ve been diagnosed with psoriatic arthritis & am on methotrexate and sulfasalazine to manage this. I’ve really cut down on drinking alcohol due to the risk to my liver, but about a week ago I had a few drinks, maybe 8 units or so, and experienced a short lived ‘black out’ from my memory during which time I was talking nonsense, almost like a fever delirium. Has anyone else experienced something like this, or have any information about the effects of methotrexate + sulfasalazine + alcohol? Although I’ve been told it’s OK to drink small amounts, infrequently, this recent experience has left me quite shaken up and I’ve never experienced anything like that before.

Any advice, stories of similar effects or links to information gratefully received.

Thank you.


  • Ellen
    Ellen Moderator Posts: 1,057
    edited 2. Aug 2022, 06:35

    Hi @MattCamp Welcome to the Online community.

    I see from reading your post that you have a fairly recent diagnosis of Psoriatic Arthritis (PsA) and take Methotrexate (MTX) and Sulfasalazine.

    My investigations here:

    and here:

    do not mention at all anything like the frightening experience you have described.

    A search of posts was no help either.

    It will be interesting to see whether any members have had a similar issue.

    In your shoes I would very much want to discuss the issue with someone on my medical team as soon as possible. If you aren't able to talk to your GP or Rheumatologist quickly a Pharmacist is always a good place to start.

    Please do let us know how you get on.

    Best wishes


  • MattCamp
    MattCamp Member Posts: 2

    Thanks Ellen

    I’m seeing my rheumatologist on Thursday to discuss this, so will update this thread after that.

  • Ellen
    Ellen Moderator Posts: 1,057

    Thank you @MattCamp for this and good luck with your appointment.


  • frogmorton
    frogmorton Member Posts: 27,670

    Gosh @MattCamp

    that sounded really bad must have been so scary for you and those around you.

    I hope it was a one-off but I am glad you are going to ask at Rheumatology.

    Take care

    Toni x

  • stickywicket
    stickywicket Member Posts: 26,782

    Hi @MattCamp

    A couple of things which might be useful to you.

    1. As you can see from this PubMed article, methotrexate can produce symptoms which mimic a stroke. NB mimic. Not a stroke. And meth can be resumed later. One word of caution - this is a very small survey and, with surveys, the bigger the better.
    2. So's you know whether to relate your symptoms to a stroke - I had a TIA (mini stroke) about 2-3 years ago. I'd been getting something out of the freezer and, when I'd finished, I found I was lurching all over the place. (9am - no booze involved) Luckily my husband grabbed me and sat me on the bed. I tried to explain but, like you, the words came out all wrong. (Heads up - if you can't speak properly don't try to use the word 'articulate'😉 It doesn't work.) Mr SW rang the doc and she had an ambulance round in 20mins - by which time I was fine. However, the utterly delectable young paramedic insisted on taking me to hospital and they kept me in for 3 days while they sorted me out with meds to prevent it happening again.

    I'm telling you this so's you'll know that, although you probably didn't have a TIA, you should probably lay off the beer, and maybe the meth, until you've got it all checked out. Maybe ask your local pharmacist for advice tomorrow rather than waiting for the rheumatologist. Good luck.

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