Psoriatic arthritis and methotrexate

janetv

HI everyone. I was diagnosed with PA in January after several years back and forth to my GP. I was put on methotrexate orally but have now switched to subcut due to nausea. I did initially feel better but now don't feel the metho is working at all. The fatigue is overwhelming and pain hasn't improved at all. Does anyone else feel like the fatigue is so hard? What else have people tried? I'm not due to see the consultant until August. Thanks in advance and lively to meet you all x

jamieA

Hi @janetv

I think quite a few of us on MTX recognise the fatigue that it brings. In my case it's always either the day after or two days after that fatigue kicks in for me. I think the medics suggest that it takes up to 3 months for any of the drugs we take to have an effect. If you've been on MTX longer than that and your symptoms haven't improved I'd suggest you make contact with your clinic and ask to be seen. In my case whilst they were trying to find a drug that worked for me they supplimented the drugs with steroid injections to try to give relief. These normally worked for 4-6 weeks at a time. In my case it took about 11 months from diagnosis to finding a combination that worked for me. I'm on sulfasalazine, MTX and the adalimumab biosimilar Amgevita.

I hope you get a working solution soon.

claudsl

Hi @janetv and welcome to our online community.

I have psoriatic arthritis too and I used to take methotrexate. It made me so sick and fatigued, I tried both the tablets and the injections but in the end I had to stop as I had no quality of life. I moved on to biologics and they are brilliant. I don't get any sickness and they are really effective with pain management. It might be a good idea to discuss this at your next appointment, or if you feel you can't wait that long perhaps give them a call to see if something can be done sooner. I know people who have no problems with methotrexate and it works well for them but it definitely didn't agree with me.

Good luck and take care

Claudia x

Arciere

hi @janetv

I have a similar story to Claudia. So +1 for that.

I would say do push for an earlier medication review, if you’ve been taking for 3 months already. The rheumatology advice line, if your hospital has one, might be better then a GP route.

What I’ll also say is try to avoid making decisions about medication yourself. After methotrexate I was moved to sulfasalzine which I complied with for three months but after feeling so poorly and frustrated I took it upon myself to stop taking it and nit renew my prescription. This had an adverse effect because it was doing “something” and I became really quite poorly until I was prescribed a biologic. In the interim period I found oral steroids worked really well.

Hope this helps and I promise you will find the right mix of medication for you in due course, it’s just the passage of time which frustrating.

Hope this helps

betsyboo

Hi all,

I have just started methotrexate and the fatigue is what is affecting me the most. I have only been on them for 5 weeks but my depression is the worst it has been for years. I have a 6 week review next week so I hope they can help meto deal with this.

I hope you are all doing OK it's interesting to read your experiences. I hope you all have a good day x

MaryL44

Hello @betsyboo and welcome to the Community. We are a friendly and supportive group and I hope that will be your experience as well.

Our website is a mine of information so do look at it. You might be particularly interested in:

https://www.versusarthritis.org/about-arthritis/treatments/drugs/methotrexate/

https://www.versusarthritis.org/about-arthritis/your-experiences/your-questions-answered/your-questions-on-methotrexate/

Also, our community members will have vast experience so keep checking back here for their responses. You can also search for previous chats about methotrexate. It's a subject that comes up very often.

Personally I have been on methotrexate for a while but thankfully had no problems with it. But my advice would be to make sure you use your six week review to tell your health professional exactly how you feel and discuss the alternatives. Methotrexate can take at least 3 months to improve your symptoms but if it is making you feel bad in other areas you need to discuss it with the RA Nurse.

Please keep posting now you are here and let us know how you are getting on.

Best wishes

Mary