Even though the Methotrexate (MTX) has overall started working well regarding RA pain, there's a real dilemma. This week I was only sick for one day (Sunday) and was good to go on Monday with only a pain level of 4-ish, which for me is baseline. That's six good days and one bad day. Probably acceptable, but that one bad day is unreal.
Then it's gone by the next day (!), along with the other bad side effects, but whoa, I am a different person on that "down day." I know I'm not nuts, and so I looked it up -- mood swings on methotrexate are not uncommon, some bad enough (and longer than the down day) to require anti-depressants, or so bad they have to get off of the drug.
Methotrexate can also cause mood changes. Depression and/or anxiety caused by methotrexate therapy can be serious.Dilemma
At least for me, after trying all sorts of other meds that give me fewer days of relief and more bad days of side effects, I'm willing to ride out MTX for a while longer, but I definitely need to be cautious about that down day. I feel like I probably need to stay in bed and just let the tidal wave of side effects and bad thoughts hit, and write off Sundays all together.
Not a great trade off, and certainly kind of scary. But I have to see if it will pass. The number of days that I am sick from MTX is down to one after starting out at 3. I'm only about 8 weeks into trying this drug. I have to check in with my docs by the end of the month. I've alerted them about the mood side effect and that I am monitoring it.
This is the price those suffering with RA have to pay as they go on the merry-go-round of trying to find the treatment that works best and destroys quality of your life the least. The motivation is to stave off the 24/7/365 crappy quality of life you have if you don't treat this degenerative disease at all.