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surprising result from rheumatologist

I saw rheumy doctor at hospital yesterday and he went through my recent x rays with me. My hands, (wrist and thumb joints) are quite bad and my feet and knees are showing "degenerative changes" too. He is arranging for me to see a physiotherapist to help with my general problems and also a specialist physio for my hands (which are very bad) However, although I said I don't feel any better than I did 2 mths ago at last visit, he said he thinks the sulphasalazine and mtx injections are getting it under control as my bloods have improved. He thinks that fatigue caused by pain is effecting my general well being and has (to my astonishment) prescribed seroxat anti-depressant and also (to help me sleep without pain) a small dose of amitriptyline to take mid evening. I DO feel very down with the RA and also other problems recently but did not recognise it as depression as such. Has any one elses Rheumy prescribed this combo? Thanks x

7 Replies

I have had amytrptalyne before today,i am off them now,but i am on certraline as an antidepressant. Depression seems to go hand in hand with ra i am afraid.. Its lovely that he is looking at you as a whole person rather than the bits he knows about.xxxx


I agree with Sylvia. One condition exhasarbates

the other. Glad he is treating you well.




I saw mine last week and had a similar conversation. Have been prescribed Amityptiline only to help with pain/sleep and consequently fatigue. I have thought I was becoming depressed but want to try other ways of dealing with that first and think if the pain/fatigue improves my outlook will too. Meditation is my next port of call, realising you need an armoury to deal with this disease............



Aw he actually sounds very caring! I know I have mentioned the real help I got from a counsellor in dealing with the changes to my life Tess. It sounds like your Rheumy noticed it too, antidepressant after a while really make u feel as though ok the problem ie RA is still there but the weight has somehow been lifted from your shoulders. The talking therapy and CBT made me manage day to day and stopped me having feelings of negativity or laziness, well most of the time!

Amitryptalline and me didn't mix though, I got them for nighttime muscle pain but they gave me nightmares, but of course everyone being different loads of people here use it with great effect.

So overall you know Tess, it's a huge step in the right direction! And if the antidepressants don't suit you it's like the RA drugs tell them, there are loads of them so they should able to find one for you, hopefully the one u have now. Sending u hugs, think of it as another step in the RA journey to getting there! Xxxxx


Sounds like a good rheumy. hopefully it will give you the boost you need, and with better sleep and not feeling as stressed it could even help the drugs control the RA. When I added sulpha into the MTX/Hydroxy mix it did take many, many months to make a difference. Pollyx


Thank you so much everyone - my RA friends are as good as any tonic ..... x x


Hi, I'm on amitriptyline in an evening too,not as an anti depressant but to help relieve pain & muscle spasms. (Pain clinic prescribed) & hopefully help sleep. (In low doses its good for pain relief, for depression you'd need over 100mg) if you find it leaves you feeling 'hungover' just take it a little earlier. It makes me really dry/thirsty,so lookout for that. Good luck with physio & the meds,xx


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