Methotrexate for RSD Joint Pain?
 

Hi all
I have been having really bad pain in my knee joints and elbow joints- My brother -in-law took methotrexate for arthritis and it worked great! (The arthritis that is associated with psorisis)

Im gonna ask my PM doc about it- Anyone have any thoughts?

Deb

Yeah, I have a thought. Rheumatologists use it in treating RSD, especially in combiniation with Infliximab (Remicade) and it apparently works pretty well, especially on celebrities because Remicade is an orphan drug when it comes to RSD and since it costs roughly $1,000 every six weeks, most insurance companies won't cover it. (The same may be said for Methotrexate, but it's cheaper.)

The only thing is that Methotrexate is a chemo agent that was NEVER designed for long term maintenance use. I know that my internist is adament that I not go on the therapy. Check out the Medline blurb on it here: http://www.nlm.nih.gov/medlineplus/d...r/a682019.html

And here's link to the full insert from Drugs.com: http://www.drugs.com/pro/methotrexat...ml?printable=1

Personally, I think the most interesting and hopeful treatment out there right now is something called "right-unilateral electroconvulsive therapy (ECT)." It has gotten very little press, but the beauty of the thing is that it doesn't have the same cognitive side effects as the more conventional bi-lateral ECT. But that's the subject of another thread altogether. In the meantime, and admittedly going off-topic, check out, "Treatment of CRPS with ECT," Marie Wojcik Wolanin,MD, Vasko Gulevski, MD, and Robert J. Schwartzman, MD, Pain Physician 2007; 10:573-578 (containing a remarkable case report of full remission over a number of years following treatment with bi-lateral ECT for depression associated with her CRPS.) Be assured there are other citations, which I will post in the approriate thread.

Mike

TY
 

Thanks for the info! Scared the Sh** out of me using the methotrexate but I am Definately interested in the ECT! Why is there not anything being done about it! Have u talked to any Drs about it- I use to kid my friends and say I want a Labotomy...Let me know if you have any other info

As always you have great stuff to share

Deb

My pleasure. Give me a couple of days and I'll have much more. The question of why more hasn't been done about it is perhaps one of the most intriguing of all, my best guess is that the side effects of bi-lateral ECT scared off most doctors who looked at this - although in cases of extreme CRPS there is definitely a quality of life calculation to be made - while at the same time right-unilateral ECT had acquired an unfair reputation as being inaffective for pain, even though it's currently the preferred choice for "major depressive episodes": just as effective as bi-lateral but without the side effects.

Mike

Hello Deb,

Just want to tell you my Methotrexate experience but whilst for me it was not good I do know that some people report improved deep muscle and joint ROM and Pain and little in the way of side effects.
I had been taking it for about 10 days when I started vomiting/diarrhoea etc.
My urine output had reduced to almost zero and I started convulsing.
In the early days I turned bright red at just the tiniest bit of sunlight too.
I guess it is up to a big discussion between you and your doctor and a willingness to find out what category you are going to be in.:confused:I wish you luck if you decide to go ahead.


Hey Mike,
I will be the first to put up my hand for ECT, when it becomes an accepted treatment here. We are close I think but my Pain Doctor has been wanting to try for a few years. It makes a huge amount of sense to me:)

Good luck guys
Tayla:hug:

I'm right in line with you Tayla .
My PM doc is just waiting for the get go from the medical establishment - and he is in !!

Who needs a memory anyway :D

Perhaps one day they will get to the point where docs can selectively zap the memories we want to "delete " from our memory banks- pretty kewl- no ?? :cool:

I look forward to more information dear Mike ;)


Peace

GnP

Debbie,
I really hope that you can get the pain under control. Sorry that I can't help you further, but I just want you to know that you are in my thoughts. Please keep us informed.
Take care
Pain free hugs
Love
Alison

autoimmune
 

issues typically are used to decide on methotrexate therapy.

Methotrexate is a serious decision. Alot of potential downsides:
stomach damage
damage to the bone marrow
lowered white cells -- increased risk of infection
osteoporosis
many other problems

http://www.nlm.nih.gov/medlineplus/d...r/a682019.html

It is not just for "pain". I'd research it carefully.