Does the side effect of brain fog and exhaustion eventually pass from Methotrexate?

[artc1]

I have just started Methotrexate but am having extreme fatigue and brain fog with it. Will this pass eventually? eventu

[bpeal1]

For many it does, however for me it didn’t. If you’ve tried it for several weeks and it is getting worse contact your rheumatology team and discuss it with them. Don’t despair, there are plenty of other medications you can try and unless you contact them they will assume you are doing ok. In the meantime have a look at this booklet. nras.org.uk/product/medicin...

[artc1 in reply to bpeal1]

Thank you for your response! What I'm wondering specifically is how long I should wait; I'm losing precious time to the brain fog and exhaustion. I've only been on it a week, and it feels more like a month. Do I give it until the end of February or till the end of this week before I give up? I'm already on Hydroxychloroquine (4 months now) and have also tried Leflunomide. How long did you wait before you went off of it?

[bpeal1 in reply to artc1]

I gave the tablets about 6 weeks and then I tried the injections for another 5 or 6 weeks. Many people find that the side effects do improve so it’s definitely worth trying to persist a little longer. For me though the side effects seemed to get worse each week.

Only you can decide how long you can keep trying. Speak to your rheumatology team first before stopping. It might be worth increasing the folic acid. Good luck with whatever you decide.

[artc1 in reply to bpeal1]

I don't plan on stopping; I'm just trying to get an idea of what is typical for most people. I work very closely with my Rheumatologist, and he has already said I can stop if I need to and we can try something else. Thanks very much; I appreciate your response.

[bpeal1 in reply to artc1]

As with all things to do with RA, frustratingly there is no ‘typical’ everyone reacts differently both in terms of how well something works and what side effects may occur and also how well we tolerate any side effects.

[welsh12]

Took me about 3 months to get used to it it works well for me the day after taking it I can still be a little tired and mild brain fog 18 months on. Pros and cons.

[Brushwork]

I agree with bpeal(1.

I’d add that the decision is yours to make. Personally, I value my time and quality of life but I wish I had switched drugs much sooner as methotrexate side effects led to a bout of severe depression for me.

These days there are much easier to tolerate and more effective drugs, but clinicians have to go through the process, which to my mind is outdated, before they can prescribe the more expensive but also better tolerated meds.

I’d urge you to strive not only for relief and remission, but quality of life too, and as quickly as your team will allow.

[artc1 in reply to Brushwork]

Many thanks; your response is so helpful. It's the quality of life that I'm missing, and I'm only a week in. I need to be able to function, and right now, I'm barely able to with the severe brain fog and exhaustion. Luckily, my doctor has already said I could change it quickly if it's not working for me. I'm going to call his office today.

[helixhelix]

i find that it generally takes me three months to acclimatise to a new drug.

[Sebastian247]

I think you need to give it a reasonable amount of time, to both hopefully work and to adjust to it. I would think in terms of months rather than weeks. Initially once I'd increased the folic acid I had a period of not feeling too bad. The brain fog and fatigue were there but tolerable. Unfortunately after a year it got much worse which turned out to be neurotoxicity and after 18 months I was taken off it. Hope the side effects ease soon. Seb

[Gramma3]

It improved when they changed me to injections and increased dose. 8 weeks ish, worse for a couple of days each week. Sleep improved it after I started small dose of Amitrytaline.