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What are the best medications to treat this?

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Posted 9/29/2011 2:04 PM (GMT 0)
Are there certain medications better than others to treat connective tissue disorders?

Plaquenil, doesn't control fatigue for very long, it really isn't all that great at controlling pain..

Immunosuppressives, any more effective than the other ??

Prednisone, I hear that one controls fatigue, but I also here it can come with some nasty side effects, like disfiguring your face making it round and puffy, a 50 lbs weight gain in a month!! I mean... Wow! Any way to avoid the side effect.. Can you reduce your sodium intake, if your appetite increases, to not respond to overeating, would it keep you from gaining all that weight?

Can you take prednisone daily or is it only used during flares?

I am taking plaquenil, I have tried an immunosuppressant, haven't tried prednisone yet but it's being suggested.

My pain is controllable with NSAID's, nerve pain medication, and muscle relaxants. My fatigue, is not at all under control. I need suggestions please !!!

Posted 9/29/2011 2:25 PM (GMT 0)
Complicated subject and every patient responds to treatment differently.  There is no med that will make fatigue go away although it should be reduced if you go from a flare to drug induced remission.  I have been in remission for almost 6 years but still have fatigue. 

 What is your diagnosis and symptoms?  Plaquenil is commonly used for mild cases of lupus and often works well for those.  Not for more severe cases and usually not for overlapping connective tissue diseases if that is what you have.  Prednisone is often the first treatment to try and get things under control quickly.

There are lots of possible side effects from prednisone but you will not get all of them.  It is a drug that is used because it is fast acting and usually effective.  Most docs will introduce a prednisone sparing drug and taper or eliminate pred.  You do not gain 50 lbs in a month from pred...only from over eating.  Pred does change your metabolism (varies in each individual) and some do gain weight but I was on it 6 years and gained nothing.  I adjusted what and how much I ate so that I did not gain weight.  No matter what weight, gain is calories in vs. calories out.    There are many very serious side effects to long term and high dose use of pred like osteoporosis, hypertension (the only serious side effect I had), diabetes, cateracts/glaucoma, and like all immune suppressing drugs you are more vulnerable to infections and cancer.  Moon face is a redeposition of fat which can also be in the belly and neck/back.  This reverses by itself as you reduce dosage and is not a net gain.  To avoid weight gain you should adjust your eating habits particularly if you have become more sedentary.  Many patients do not do that.  Also avoid simple carbs.

Any suppression med is best taken daily but pred dosage can be increased to combat flares.  This should always be done under the supervision of your doctor since pred is a powerful drug with many effects.

http://www.gihealth.com/html/education/drugs/prednisone.html

http://www.drugs.com/sfx/prednisone-side-effects.html

Don't anticipate what is going to happen to you.  Report any changes to your doctor and you can make decisions as problems develop.  Prednisone is a love/hate drug but it has saved lives and sometimes is the only drug that works.  Usually there is a better long term treatment that has fewer side effects.

Bill

 

Posted 9/29/2011 10:37 PM (GMT 0)
My disease is overlapping and I have too many symptoms to make a list. Thank you for the information. :-)

I start prednisone in the morning but I'm nervous. Already have some weight disproportioned to my stomach, so what's prednisone going to do really? Well I'm not that big, like 150, but I need to lose some, not gain it. I can control my appetite, I think. I eat low calorie foods so maybe it won't affect me really bad.

All of those side effects are diseases that run in my family. I figure if I get one, it'll be hypertension, but that'll go away if you stop the drug, right?

 

Posted 10/5/2011 2:42 PM (GMT 0)
Plaquenil is really helping with my fatigue to the point where I almost dont know what to do with myself because I am staying up later and yawning less at work, even my co-workers have noticed! I seriously would yawn about 20 times a day. Its also helping with my lymph nodeinflamation. I agree with the aches though I still get them I havent been on long though.

So I would say Plaquenil does work but everyone is differnt. Also as Bill brought up Plaquenil commonly helps for mild cases of lupus which as of right now is what I am considered to have.
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