Question
Dear Rusty,

I've had RA for about twenty years now and have taken so many different drugs I probably wouldn't remember all of the them.  I took methotrexate many years ago and do not remember why I stopped.  I believe I found I did not get enough "bang for my buck" at the time.  Well, I/ve been back on it now for about a year, along with prednisone and sulindac.  In the past few months I notice I have very few days where I can get much done and I've been sleeping a lot during the day.  Well, I ran out of my metho prescription last week and, instead of taking my usual eight pills, I only took three.  I had some mix-up with my doctors and tests and wound up not being able to get my pills until yesterday.  I did not take them.  You see, I've been full of energy, shampooing carpets, moving furniture, scrubbing floors, putting away winter clothes, and on and one.  This has happened before.  I will feel wonderful for a day or two and then down I go, but this seems extrordinary.  Boy, I wish I could make a long story short, don't you?  What I really want an opinion on is the possibility of feeling so much better without the drug.  Have you heard any comments on this?  I am not due to take my dose until Saturday morning, but if this "high" lasts, I have no intention of taking them.  Oh yes, my tests came back "not so good" this time and the doctor wants me to take Lipitor.  I rarely have any high cholestoral numbers. Any information you may have collected on this subject would be appreciated.  I find doctors tend to be a little patronizing when you think you may have come up with an answer on your own.

Sincerely,
Bobbee Boothe


Answer
Bobbee,

I am not surprised that you have more energy when you are not taking Methotrexate. Fatigue is the number one side effect of Methotrexate. One thing to note about Methotrexate is that it can take a week or so for the full Immuno-suppresent effect to where off. This mensa that the arthritis symptoms are still being suppressed for a week or so after coming off of the drug. It is your body and quality of life issues are as important as pain reduction. What good is treating the arthritis symptoms if you loose the rest of your life.

An option you have is to have a discovery time. In this you do as you mentioned and miss one or two more of the doses and see if you are still full of energy and how much pain has returned. It you continue to feal so much better demand that your doctor try something else.

Rusty
http://arthritis-symptom.com