I Want to Stop Methotrexate

[Forest Walker]

I'm just going to whine.  The nausea and headaches with oral MTX are bugging me.  I'm seeing my dermatologist on Tuesday and will ask about switching to the injectable, as Dave recommended.  But I also miss sharing a glass of wine with my partner.  And I would like to enjoy a bourbon, now and then.  

The MTX has been working, though.  But the nausea and headaches are not so fun.  Possibly, the headaches would persist with the injectable form, even if the nausea abates.  

I'm going to read up on Interleukins and try to understand them.  My gastroenterologist said that Stelara works for both Crohn's and Psoriasis.  Humira targets TNF-alpha, not the interleukins.  

I'm grateful for the information on these various medications in Psoriasis Club.

[Caroline]

Hi Forest..

I am not surprised. I only was able to use it for about two months and then decided that it was not for me.
I don’t know how it differs if you have an injectable. I considered the stuff as so bad for my body that I did not want it at all anymore.

MTX is an overall strong immune suppressor. The whole of the immune system is pushed downward.

TNF-alpha inhibitors block a part of the pathways in the immune system that causes the inflammation to occur. (Never used them) So it also is kind of an overall suppressor.

Interleukine or Cytokine blockers work mostly on IL-23 or IL-17 or IL-17a, and perhaps some others, but these three are the most significant for Psoriasis and Psoriatic Arthritis.
Overall it seems that IL-23 is most effective for psoriasis and IL-17 is mostly effective for Psoriatic Arthritis. Though it appears that both work more or less for both.

The interleukines often work much better than the TNF-alpha or MTX.
Indeed the work for both Psoriasis and Crohns.

Which may be logical if you consider the human body as kind of a pipe, with the skin on the outside and the stomach and intestines on the inside, so basically also the intestines are built of the same material as the skin. Ergo… the effect of the medication is on both.

[Fred]

It's not unusual FW, methotrexate can work but not for long and 9/10 will feel nausea from it. I found it also made me feel like a zombie all the time, as for the injections for me it was just as bad as the tablets and I even found it gave me mood swings but that could of been down to me hating the stuff.

Stelara would be your best way to go Stelara (ustekinumab) and you can have a drink whilst using it.

At the end of the day it's your body and you have to decide, but in my opinion methotrexate should not be used today for psoriasis.

As for stopping it, I think you can just stop using it but I would discuss that with your doctor.

---

*I'll move this to Prescribed Treatments For Psoriasis

[jiml]

I can't say I blame you FW I lasted a few months on MTX before I decided I'd rather have psoriasis than feel constantly nauseous, I got to dread Mondays (my day for taking mtx)
I was fortunate enough to have a professor in the Doctors traning school where I used to be a willing practice patient suggest that I ask my dermatologist about DMF treatment which I did and was able to get off methotrexate.
I would certainly do your research here on the available alternatives and like Fred and Caroline said biologicals are your best way forward, and Stelara  is well tolerated by most and with that you can enjoy a glass of wine to make life more enjoyable

[Wooley]

I can't blame you Forest, my next option would have been methotrexate - I refused point blank to entertain that and fortunately for me didn't have to go down that route - I truly believe that this should not be used as an option for Psoriasis (but that is just my opinion of course).

Really hoping you find a better option going forward Forest....

[Caroline]

Not only your opinion Wooley, Fred and mines too.

[D Foster]

MTX can work well especially when taken by injection I was on it for many years, there's many other treatments that,in my opinion, are much worse than MTX. Cyclosporine for instance among others but Stelara which acts on interleukin 12 and 23 is extremely good but at the end of the day each of us are individually prone to different drugs so what works for one doesn't necessarily work for another.

[Forest Walker]

Hi Forest..

I am not surprised. I only was able to use it for about two months and then decided that it was not for me.
I don’t know how it differs if you have an injectable. I considered the stuff as so bad for my body that I did not want it at all anymore.

MTX is an overall strong immune suppressor. The whole of the immune system is pushed downward.

TNF-alpha inhibitors block a part of the pathways in the immune system that causes the inflammation to occur. (Never used them) So it also is kind of an overall suppressor.

Interleukine or Cytokine blockers work mostly on IL-23 or IL-17 or IL-17a, and perhaps some others, but these three are the most significant for Psoriasis and Psoriatic Arthritis.
Overall it seems that IL-23 is most effective for psoriasis and IL-17 is mostly effective for Psoriatic Arthritis. Though it appears that both work more or less for both.

The interleukines often work much better than the TNF-alpha or MTX.
Indeed the work for both Psoriasis and Crohns.

Which may be logical if you consider the human body as kind of a pipe, with the skin on the outside and the stomach and intestines on the inside, so basically also the intestines are built of the same material as the skin. Ergo… the effect of the medication is on both.

Thank you, Caroline.  Your information above is an example of the knowledge in this forum.  Collectively, the experience, research, and willingness to share in this forum aid in creating a meaningful, helpful place.

[Forest Walker]

It's not unusual FW, methotrexate can work but not for long and 9/10 will feel nausea from it. I found it also made me feel like a zombie all the time, as for the injections for me it was just as bad as the tablets and I even found it gave me mood swings but that could of been down to me hating the stuff.

Stelara would be your best way to go Stelara (ustekinumab) and you can have a drink whilst using it.

At the end of the day it's your body and you have to decide, but in my opinion methotrexate should not be used today for psoriasis.

As for stopping it, I think you can just stop using it but I would discuss that with your doctor.

---

*I'll move this to Prescribed Treatments For Psoriasis

I had been hopeful, especially since a long-time friend from Oregon has a husband with adult-onset rheumatoid arthritis.  MTX helped him tremendously, and he had no negative effects.  He must be the one of ten who doesn't.  

If I can just stop using it, then last Thursday's dosage will be the last.  I see the dermatologist tomorrow morning and will find out.  

Even if the injectable form alleviated the nausea, the headaches will likely persist.  It's so terribly uncomfortable to try to work and teach skating while having these headaches and nausea.

[Forest Walker]

I can't say I blame you FW I lasted a few months on MTX before I decided I'd rather have psoriasis than feel constantly nauseous, I got to dread Mondays (my day for taking mtx)
I was fortunate enough to have a professor in the Doctors traning school where I used to be a willing practice patient suggest that I ask my dermatologist about DMF treatment which I did and was able to get off methotrexate.
I would certainly do your research here on the available alternatives and like Fred and Caroline said biologicals are your best way forward, and Stelara  is well tolerated by most and with that you can enjoy a glass of wine to make life more enjoyable

You folks do understand.  That really helps.  I'm dreading Thursdays, my day to dose the MTX.  

You were lucky to have the DMF suggestion by the professor in the training school.  That made a huge difference for you.  

My scalp, torso, arms, and upper thighs had cleared.  But in the last two weeks, my scalp has had a little itching.  Two teeny, tiny patches have appeared on my face.  My ears, also, appear to have begun recurrence.  So maybe the MTX isn't as effective, now, as it was just over two months ago when I started using it.  Or, maybe the light therapy has worn off.

I think I would rather have the psoriasis than the nausea and headache.