Can sulfasalalazine cause severe depression?

[Joansy]

Can anyone advise me here? Just feel dead inside and constantly crying.

[Hidden]

Well I got very ill on Sulfasalazine so had to come off after three weeks when I suffered from dramatic swelling in my neck and around my ears and a terribly itchy all over body purple rash. However before this I felt very low while taking it - but then I was newly diagnosed and in shock so it could have been that - but I remember being relieved when my GP said I couldn't go back on it because of the reaction and feeling really jolly once I stopped taking it despite the worsening RA pain.

[AuroraB]

Hello Joansy. I am sorry you are feeling the way you are - please do reach out to your GP or someone professional who can help you. There is a helpful page on the NRAS site, which has some useful links on it.

nras.org.uk/depression-and-...

There are lots of causes of feeling the way you are feeling and speaking with someone who understands your medical condition/s may help you. There are lots of people on the site who can and will be supportive to you, but some things need professional input too. Its a hard struggle for many at this time of year with arthritis and all that it brings but as I said, there is lots of support from NRAS and the people on this site to help you with your arthritis journey.

[hatshepsut]

Whatever the reason for you feeling like this, you need some help and advice ASAP. You've taken the first step by posting here, perhaps the next step is to tell your gp how you are feeling.

I have no idea whether the cause is your med, but I do know that depression is very common with RD, I suffer with it myself, so I know how hopeless and alone you can feel.

Please do believe that you are not alone, there are lots of us trying to cope. However, we all need help at times. Do talk to your doctor, and let us know how you are. NRAS have a helpline if you want to talk things through with someone.

I do hope you feel more positive soon. Do keep in touch. M xx

[farm123]

What other meds are you on because for me some of the anti-inflams will cause depression. I was unsure whether medication was affecting me and by chance one morning I was late taking the anti-inflams and was feeling more settled until just after taking them and then it hit me again. At other times it is this *** disease which can get you down with constant pain, tiredness and not being able to do what you want. You may need a medicine review as things may not yet be controlled properly. Everyone is different so please do contact either your GP, rheumy nurse or NRAS helpline. Farm

[Hidden]

I went into deep depression after I had my steroid injections ,but look back I think its the shock of this nasty illness ,when I say this site has been a life line to me I mean that the new friends I have made have seen me through the dark hours hope you feel better soon just hang on in

[Joansy]

Thanks everyone for your responses here..., greatly appreciated. I have had osteoarthritis since my mid twenties and am now almost 54. I have had various pain meds, anti inflammatory drugs and antidepressants over the years...pain and depression do seem to go hand in hand I have found. My consultant diagnosed me about 6 months ago with inflammatory OA as I have flare ups and this is when it was decided to try the sulfasalazine. I did go to my GP and she changed my antidepressant and it has since been increased. She queried the sulf at that point but I wanted to see if it would help pain etc. but I don't know if it has. Decided I am going to wean myself off and see if there's a difference as I can't go on like this.

[nomoreheels in reply to Joansy]

Hiya Joansy & welcome. I'm sorry to hear you've had this reaction to sulfasalazine. You've received good advice, little I can add except that it's not necessary to taper sulfasalazine. I have RD (RA) & OA & of similar age to you. I would recommend if possible you make contact with your Rheumy or Nurse to question if there is another med which could replace it, rather than just stopping & having nothing controlling your OA symptoms if it did indeed work, though it does sound as though it wasn't doing an awful lot except these awful side effect. You obviously need some help, & quickly before it worsens.

I hope there is something else they can offer you, OA pain can be so wearing, especially so if you flare regularly. Your inflammation needs controlling with a regular med, one that you tolerate of course! But remember in the meantime, we're here if you need contact or the NRAS helpline may be another option if you feel you'd like someone to talk to, freephone 0800 298 7650.

[Hidden in reply to Joansy]

As Nomoreheels has said you don't need to wean off Sulfa - you can just stop and see if the depression lifts as it did quite rapidly for me (maybe a few days but will probably take a bit longer for you as it's more in your system). We are told this is a rare side effect but unless people fill in a yellow card at the time (I didn't know about this then) it's not always possible to gage how rare. Having been on this community for a while I think depression as a result of certain drugs, Sulfasalazine included, is more common than is often acknowledged.

I hope you can speak to your GP or rheumatologist about this very soon and that you feel much better soon too.

[topcat111]

Morning, I can say from experience that sulphasalazine gave me very bad depression! It is a known side effect of this drug! I was taken off it and there are others you can try! I now take mtx injections and hydroxy! They work for me as best they can! Like someone said earlier it is that tuff season! Stress will add to your symptoms as well. See your gp or your Rheumy nurse! They absolutely know best! Best wishes and good luck! X

[norfolkjo]

Sulfa dragged me down very quickly . I had never had depression so cant blame anything else. I was put on metho and sulpha reduced to two tabs not four and I stabilised xx

[Adelaide1]

Hi...yes I suffered a very bad depression after taking sulfasalazine....I couldn't understand why I had gone down so quickly, I emailed my consultant, who rang me straight back and said to come straight off it. Apparently it is quite rare, she had only had one other person that it had happened to. It took me a while to recover, but it started to pass after 2 weeks or so. Best wishes.

[Joansy]

Thanks so much folks. Are you 100% sure I can just stop though? I have been taking 5 daily and reduced it to 4 this morning but I would much prefer to stop immediately if I can.

[nomoreheels in reply to Joansy]

There is nothing written up advising to taper sulfasalazine Joansy. Similarly if we have problems with methotrexate & other DMARDs we are asked to stop until tests are performed/results received to determine any abnormal bloods results. I would advise though that you don't stop taking them of your own accord though. This should be discussed with the prescriber, Rheumy or Nurse Specialist. This link medicines.org.uk/guides/sul... section "Stopping your medicine" explains further.

I understand your reasons & why you want to withdraw your sulfasalazine but this should be under the direction of the prescriber as I think everyone who replied agrees. He/she needs to be aware to enable him to discuss possible options for you with as little hiatus as possible in treatment. Makes sense really, if you stop taking them without something else in place your symptoms remain unmedicated until you see your Rheumy. If that's not possible or you don't have an appointment any time soon it could be worth seeing if your GP would sanction it but do remember they often won't override a Specialist & ask you to confirm his ok.

[Adelaide1 in reply to Joansy]

Contact your rheumatologist, I am sure you will be advised to stop immediately as I was.

[Joansy]

Thanks again. I'll do just that and let you know how it goes.

[hatshepsut]

So pleased you've had such good advice. I was really worried about you, do keep in touch and let us know how things are going. M x

[cathie]

I just wanted to underscore the idea that RA can give rise to depression. It is a life-changing condition and sometimes the reality of the situation can overcome you. I hope your depression can be helped by coming off sulpha. Try to get out and see the (rare) sunshine these dark winter days, that may help to lift your spirits too.

[Snorebitz]

Hi, I found it made me feel depressed and anxious even after only taking it for a short time (few weeks) and rang rheumatology - they stopped in straight away and changed to an alternative with which I had no side effects at all (leflunomide).

About fifteen years ago I took a new wonder drug (for pituitary tumour, not auto immune related) and it made me extremely depressed and anxious. I did not seek help nor understand it was the medication and ended up a 7 stone (I am 5ft 10 tall) annorexic having a nervous breakdown.

As soon as I started feeling peculiar on Sulfasalazine, I monitored it and then rang my rheumy. They did not seem in the least surprised.

[Hidden]

Hi Joansy,

Sorry to hear you are feeling depressed but as many people have said here, you are not alone and can call our Helpline team if you want to talk to someone in confidence. We also have the peer to peer support network so you can speak to someone with RA who has been in a similar situation to yourself. Give us a call on 0800 298 7650 if this would be of help to you.

As per the other comments above, I just want to also urge you to speak to your rheumatologist before changing or stopping your treatment. Let us know how you get on.

Best wishes,

Ruth Grosart

HU Admin

[Joansy in reply to Hidden]

Thanks Ruth... I have just called and left my phone number as all the lines are currently busy.

[Hidden in reply to Joansy]

Sorry about that, I'm sure one of my colleagues will get back to you shortly! Thank you.

[Joansy]

Yes I have no doubts....thanks again.