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MTX High?

My Dosage was raised to 20mg after my last visit with the Consultant.. i've since noticed that im very hyper & not sleeping as long or deeply.

On the lower dose this 'high' used to wear off by Wed when i'd get a bit tired and achey (I split my dose and take 3 times over a Friday)

But with the raising of the dose the high kicks in around an hr after my first tablet and remains all week...

I've probably had 6 hrs sleep in total this week.. lol!

Should I be worried?

13 Replies

Gosh, never had that before!

sorry, I'm not much use but thought I'd say hello, how are you keeping now? weren't you just diagnosed recently?


Hey Wilby!

Yeah GP diagnosed in April then a Looong wait for rhemy appt, I just started the meds in June :) as well as a new job in a new city! (which is going very well)

Meds are 'sort' of working I guess? I dont feel as wretched since I started them. The consultant raised the dosage as he didnt think I responding well enough & my DAS score was raised, its still early days on the RA journey so cant complain :D


Gosh!!! nor have I, wish I could get a high! I take 20mg a week actually just popped my 2 x 10mg tabs! I was put down to 15mgs once & noticed an immediate disimprovement! The opposite effect with me more tired for about 24 hrs after dosage, I also never heard of splitting your mtx dose, but different strokes for different folks!

Good Luck :)


Hey Hon!

Hows it going? I've been tired, believe me... so even though this feeling is really weird im rolling with it for now. LOL

I've a sensitive stomach so rheumy suggested I take my MTX over the whole day to lessen the hit to my system. So far I dont get the nausea or headaches so its working I guess :D


Most people get more tired??! which is as Gina said for the next day or even two!

Are you taking another meds?? steroids can stop you sleeping/ cause a High?.. think a cht with your GP is a good plan. to sort this out or rheum team.


Hey Summer,

Im also taking Placquenil and Steriods. Hmmm it could be the steriods as they've been raised from 5mg to 15mg. Although, I was on 30mg in April and didnt feel like this. Which is why I thought it might be the MTX as this is a new drug to my system. (im asthmatic so kinda used to steriods)

I'd feel a bit rough a few days later when on the lower MTX dose, but since the dosage was raised im just wired (like ive had too much coffee) I can sense that im sleepy and can fall asleep normally but will wake up an hour or two later bright as a button!

I will call the specialist nurse she might have some ideas.

Cheers lovelies




The insomnia and slightly manic high is a recognised side effect of steroids. I had a long time on 60mg, then 40mg of pred for severe lung inflammation and was only sleeping a few hours plus had this weird euphoria (not unpleasant:-) ). Mania is another recognised side -effect. Definitely talk to a gp or rheumy team about this - it went when I finally got off steroids but returned promptly when I had another course.

Glad to hear that your job is going well, had wondered how you were getting on:-)


Cece x


Thanks Cece!

Glad to know im not the only one with the Weird Euphoria :D

I've made an appointment to see the GP this week.



I take 20 mg via sub cut injection ad I am just knackered!! Enjoy the high hun!!!!! Seriously tho probably best to speak to rheumy team xxx


Ye Gods Joy! - the Metho had the opposite effect for me too! I was zonked when I went up to 20mg (take them all at once before I go to bed). The nausea was worse for a while. However been on high does since February and now I am not so tired and hardly any nausea at all. But no highs!!

I should imagine that it is the combination of the extra Mtx and the steroids giving you that euphoric sense of well being. Not that I am expert.

Glad to see the job is going well because you were a bit undecided about it all when you first joined here. Well done.

Take care

Julie xxx


Hey Julie,

I actually had a bit of nausea yesterday so the higher dose of MTX is defo doing something!

Cece & Summer have me convinced now that this 'high' is caused by the steriods so will speak to the gp.

Cheers me dears



think custard.. it is the steroids .causing high.. oral steroids quite different action on system to topical steroids ie inhaler steroids!!.

I havent taken methotrexate for six months.. the other contributors are current users.. there metho tiredness is typical.. and I experienced that and unfortunately far worse things when I USED methotrexate,


Yeah you have me convinced it's the steriods not the MTX.

Cheers ducks



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