Avoiding Methotrexate

[hanny1973]

Hi - 


Newbie here, hello everyone.



After suffering from psoriasis for >30 years I have yet another consultant appointment this week. I have been using Enstilar effectively over the last year or so which does help but I have so many patches its becoming unmanageable (plus it makes me feel like I could swim the channel I'm so greasy).



I've had light treatment several times which has been effective but the psoriasis returns quite quickly afterwards.



My guess is that I will get offered Methotrexate from the consultant but I really want to avoid having to take it, with all the known side effects and lifestyle modifications. There are some much newer, more effective treatments that I would like to try. I wondered if anyone else has had a similar situation or suggestions on how to drive the discussions. 


Thanks for reading.

[Kat]

Welcome!

I'm in the states so it's a bit different here. When I first went to the dermatologist I was told to expect to be put on Methotrexate as being cheaper insurance usually require you try it first BUT that didn't happen and it was never offered to me. After topicals and one oral med (Acitretin) the dermatologist went to Stelara.

So it isn't always the next step, at least here in the US. Perhaps just let your doctor know you don't want it and ask if they can prescribe something else?

Again, welcome. This is a helpful and fun group of people who try to answer any questions you may have. There is also tons of info here on treatments!

[jiml]

Hi Hanny and    to the forum, there is a lot of information here and many personal experiences of other members and their treatments
You could start by looking at this link Prescribed Treatments For Psoriasis where all the treatments that are available are explained

Myself can sympathize with you as I had many years of ointments and light treatment which worked to a point but nothing long lasting.
Then I was put on methotrexate as here it is the first go to medication as it's so cheap . I persevered for a while but found the side effects worse than psoriasis I am now on Skilarence Skilarence and have been clear on it for the last ten years
Good luck with the dermatologist next week

[hanny1973]

Hi Kat - thanks for the speedy reply, I should have said I'm based in the UK but I think you might have guessed.

I'm in two minds whether to accept a prescription of Methotrexate and not actually take it but appreciate that's not a particularly moral approach!

[hanny1973]

Hi Hanny and    to the forum, there is a lot of information here and many personal experiences of other members and their treatments
You could start by looking at this link Prescribed Treatments For Psoriasis where all the treatments that are available are explained

Myself can sympathize with you as I had many years of ointments and light treatment which worked to a point but nothing long lasting.
Then I was put on methotrexate as here it is the first go to medication as it's so cheap . I persevered for a while but found the side effects worse than psoriasis I am now on Skilarence Skilarence and have been clear on it for the last ten years
Good luck with the dermatologist next week

Thanks for the warm welcome Jiml, much appreciated! 

[jiml]

Reading your reply to Kat I think if they insist on you trying it. Ask them what the risks are and would they take it themselves as I doubt many would

And yes take the prescription and not take it complain of bad nausea after a month and ask to move on to something less toxic 

[hanny1973]

Thanks Jiml, that's sound advice - I'll try that angle and see how it lands!

[Caroline]

Hi Hanny,

Welcome to psoriasisclub.

I can very well imagine that you dont want to start mtx, I have used it and I could not cope with it, and later on I found out how toxic it was.
Though I must admit that there are people who dont have any problem with it.

I am with Jim in how to approach it if it will be prescribed for you. You could try Jims treatment and try if you can cope with that. It is quite a harmless treatment and if it fits you then it can be a very good treatment.

There are lots of treatments nowadays so there are possibilities enough to try.

Cheers,
Caroline.

[Kat]

Well, I did have a doctor talk in riddles and mention that a lot of people don't tolerate it well.

(I got his meaning, to not take it and just come back and tell him I couldn't tolerate it so he could prescribe something else. This was the same doctor early on who was explaining the treatment steps and that I'd probably have to go on Methotrexate at some point but we skipped it and the insurance gave the okay)

But I didn't want to suggest you do something like that

I see Jim had no problems suggesting it though!

I'd still see if they'd go another direction (although some people have had good results while on it, I do feel the need to say that) and if not and you don't want to try it, well......... do what you need to do.

[hanny1973]

To be honest I wasn't sure I my potential approach would be frowned upon but thank you both for your replies and support, it's very much appreciated.

I'll see what direction the conversation goes in, I'm intrigued to see what they suggest.