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Plaquenil or Methotrexate?

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Sjogren's Syndrome
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Posted 5/7/2017 11:37 PM (GMT 0)
I have primary Sjogren's. Fatigue is my biggest problem. My joints are doing ok right now with Plaquenil, but the fatigue is really terrible. Would Methotrexate help the fatigue more? Should I switch to Methotrexate? Thank you!
Posted 5/8/2017 2:42 AM (GMT 0)
These meds perform in drastically different ways, they are not equal to each other.

Plaquneil is a disease inhibitor, slowing the progression of the disease. Usually this is prescribed upon initial diagnosis, and never stopped, no matter which of the other meds may be added to your treatment.

Then comes Prednisone, to help get inflammation under control.
Then comes one of the three, Imuran, Cellcept, and MTX (methotrexate) to treat disease activity.

None of these meds "treat the fatigue". What you probably have is inflammation and disease activity, which causes the fatigue. Once you treat the inflammation/disease and get it under control, the symptom of fatigue will lessen.

Meanwhile it is important to eat well, get deep restorative sleep, get some mild exercise, and avoid stress.

Only your rheumatologist knows the full picture of your symptoms and labs, along with how you have responded to treatment so far, to be able to suggest a particular medication that might be right for you.

Best wishes!
Posted 7/29/2017 4:16 AM (GMT 0)
Hi Lynnwood,
Plaquenil gradually became less and less affective for me over time. I recently stopped taking it because it didn't seem to be doing anything. But I started thinking, if it's a disease inhibitor, is there a chance it was still doing me good, even though I'm not feeling good? I'm wondering if I should start taking it again even though I don't notice a benefit.
Posted 7/29/2017 3:49 PM (GMT 0)
We've had many people report that they don't think the Plaquenil is doing anything, but when they stop taking it they soon find out it was doing quite a bit behind the scenes. I would never stop taking it unless I developed side-effects.
Posted 7/29/2017 4:48 PM (GMT 0)
Ok, thank you!
Posted 10/29/2017 5:17 AM (GMT 0)
Hi there. I had to go off of the Plaquenil because of surgery and other meds i had to take for a time. Thought nothing of it because i didnt think the med was doing anything any longer. I was off for almost 6 months. After being off for about a month I could really tell the difference. I'm back on it now and again feel like it's a waste of money. Wish there was really something that would help. As Dar as being tired, that's me all the time. It's just a routine for me.Can almost set the clock by how long I will last before having to sleep. There are other things that contribute but there are days I can sleep 24 hours and then oggher day I don't sleep at all. Rollercoaster aride.
Posted 10/29/2017 1:03 PM (GMT 0)
Plaquenil inhibits disease progression. That means, it keeps it from getting worse and progressing faster. We generally will not be able to tell it is doing anything unless we go off it and see how bad things can get -- which of course is not a recommend act!

And, Plaquenil takes 2-3 months to build up in your system. So in the event that you are one of the people who is actually able to notice a difference in symptoms, you may not notice them for 2-3 months.

As for 24-hours of sleep and fatigue - make sure to tell your Dr about it. They may recommend a sleep study or other treatment. In my case, I thought they were crazy when they suggested a 'sleep aid' -- why would I do that since I was already sleeping all the time???! But it turned out I was not getting "deep restorative sleep", and that the sleep aid was exactly what I needed to be able to sleep less! I never would have guessed that!
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