As some will know I'm relatively knew to diagnosis and am trying my best to manage it, being a husband and father as well as returning to work after two months off. My mood swings have been up and down which in light of every thing is to be expected.
GP on Friday told me I should try anti-depressants to help
with relaxing and pain as I've been on codine now for over three years. I'm loath to though as its been tough enough to deal with side effects of mtx and hydro let alone sertraline as well. I've heard scary things about them.
It's difficult dome times to make the right decision and you put faith in GPs whom don't always know. I have first of two appointments with Rheumy team in February so will wait before taking any thing else but do need to wean of the codine I think. Lots of pain in neck shoulder still I think they may put mtx up from 15 once a week it's so bloody difficult at times
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saffron07
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Hi not a nice place to be. But as seen on this site we do know that depression and RA are treated together with good results. Setraline or lustral, it is a Serotonin re uptaker. It is a very good antidepressant.
You should feel comfortable about taking any medication. It would be a good idea to discuss it with you rheumy team or your GP until you feel comfortable about taking it.
Thanks Catole I will chat about it more until I feel secure about it I suppose in reality I'm still reeling from it alll
Take care
Be guided by your GP.. sertraline is ssri anti dep of the newer generation( selective serotonin uptake inhibitator) .. in plain english makes your mood better by altering the levels of serotonin " the happy chemical" in the brain.
I suppose I started to read a thread some where about them and thought no way just coming to terms with mtx and hydro let alone trying this but I'm giving it thought thank you
Have you been offered Amitriptyline yet? It isn't to everyone's liking but it is non-addictive and is used in small doses for neuropathic pain. I don't take any drugs now apart from MTX and Hydroxy and Levothyroxine (which isn't really a drug as such) and folic but I do have a 10mg tablet of Amitriptyline whenever I'm a bit achy or feeling I might have insomnia from being stressed. It might be worth asking for this until you get to see your rheumy in Feb as a half way house to help you sleep and relax a bit? Tilda x
Actually I do have some prescribed but I've been hit and miss with them third 10ml which seemed to work but did take ages to kick in also tried 20 which strangely induced some nightmares. I think I will try tsking 10 about 8.00 pm see if it helps thanks
Take care
Amitryptyline at doses higher than 10mg can cause strange dreams in some people( Including me).. it is useful for pain as Tilda says .
Amitryptyline is an interesting drug at higher doses it is used for depression( above 50- 75mg starting dose) 10 -30 mg it is used off licence for things such as neuropathic pain( also aids sleep), migraines, and for altering bladder/ bowel function in people with a " weakness" in this area.
Sertraline is as I said earlier a SSRI ( Mood enhancing drug) it has no pain relief properties its chemical structure and acting pathway entirely different..
Some people are scared of taking anti depressants but be guided by the GP, depression goes with RA and most of us on here have taken some form of anti depressant.
The SSRI which got bad press is seroxat this a trade name for a different drug it is not sertaline whose trade name is lustral.
Always be guided by your local health professionals.. .. We only advise from our own experiences.
Hi Will I have taken sertraline last year and found it very helpful, I can understand your reticence and feelings about taking antidepressants as I felt much the same as if I was failing in some way. I was tried on a different antidepressant at first and this caused me some increased anxiety so was changed to sertraline. Also as a manager I could see when staff where behaving differently and could see that some of them had problems which could be related to depression which they could not see ( as I couldt at the time)
Your GP knows you and the problems with the RA are a justifiable reason to have a low mood so I would consider his advice
hi saffron, i have been on sertraline now for 2 years, it was the only thing that helped me out of my clinical depression, i haven't had any side effects as far as i know just the usual dry mouth in the mornings, hope this helps x
I've taken Citalopram ( anti depressant) for 3 years now ( 10mg) and I rebelled for 5 years before that, as I was scared to take them. This drug has helped me no end, at the time I was anxious and would get panic attacks as well as feeling low.
I don't think having a word with yr rheumy nurse is much good as they don't have enough training ( if any!) in this area of medicine. My understanding of Sertraline is that it is a mood stableizer, I have included this site I found for you to take a look at some stats.
I don't think it would do any harm in asking yr GP, why they prescribed this particular drug for you in comparison to say a modern antidepressant like Citalopram? and see what they say.
All drugs that change chemicals in the brain have the potential of causing undesirable side effects, Amitryptyline is included in this. It depends on the individuals sensitivity and the dose but that said, if the correct dose is sought, (so the side effects are few if any), then the benefits outweigh this. Often people who get side effects from these drugs stop them too suddenly/ don't wean themselves off sensibly or dose is started too high or remais too high.
Don't just take something because the GP prescribed it, they aren't god, they won't be offended because you've asked them to tell you the difference between certain drugs, after all, it's your brain :o) xxx
Saffron, i am on both certraline and amityrptaline and i have been on them for a few years now. Thye are both very good the ami, is used to help sleep and the certraline is as summer has said is a mood lifter. We have ra and it will always come with other problems. It is a no win situation and i take what will help me live a normal life whatever that is now. Give them a great deal of thought and discuss it with your gp and see if you could have a trial and see how it goes.
Thanks to you all for the information and guidance in this. I feel lucky to be able to access and get so much feedback.
Listening to all the other experiences here really does help thank you. I'm still emotionally fragile I think it's so up and down and I constantly berate myself.
RA is such an emotional roller coaster, I understand the feelings that would cause you to berate yourself, it would be so much easier if your leg had fallen off, then people would understand. Try and stay calm, (easy to say I know) but this phase will pass and if the chance of relieving it more quickly is offered, then take it, but I'm sure you'll feel a lot better if you feel the one in control, by being empowered from making an informed decision, from talking options through with yr GP. Gentle hugs, x
Hiya, like you I was very reluctant to try anything vaguely resembling an antidepressant - I know I'm a total nut job but I didn't want it medically acknowledged I finally gave in and gave sertraline a try once my GP convinced me it was just to help with pain and sleep. It did make a difference but I came out in a rather fetching rash so it was changed to amitypryline and so far so good. My sleep is still disturbed but a bit deeper and pain seems to be getting a bit better too. Still totally barking though x
Just to add to other comments, but being on codeine for 3 years is not that good and you could have problems coming off it, depending on how much you take and how regularly. Have you discussed this with your GP and is he or she aware of how much you're taking and how often? It may not be the moment for you to be able to stop taking them, as so many other things to deal with, but needs to be factored into the mix. But it is all v difficult, so not surprising that you are questioning what to do. Hope you come to the right decision for you. Polly
If you need to come off codeine, then you probably need your whole pain relief programme reviewing by a pain medicine specialist. I'd encourage you to ask for a referral to one, as they have a lot of differnt things up their sleeves - and not all medication.
I started this after a very traumatic events and told they were for trauma, as give out so quickly over the years of all the anti dep last 10 years havent worked and made me worse. I was born with psa and spinal probs and having this all life and lots of traumatic times esp at the moment as waiting challenging ops and spinal wire had snapped, long story... I just browsed and saw the name sertraline I can only speak for myself that it for me, had no side effects it dosent make you feel clouded judgement or fluffy like some meds and has helped me so much Im on high dosage of 150 - 200 at the moment but I dont feel tired like others or that horrid feeling of drowsy so for me it works and if told to try I would if things are that bad even if short time. I just wanted to share this as I have had to try so many treatments I have too much time on hands and active person in mind and find it soul destroying house bound, not able to be as independant, I am trying to make a positive thing out of this and doing a project but I would like if anyone wants to chat or support would be welcome, I research my disease and know it as all known I do the wheat free and arthritic diet I dont drink alcohol as makes flare up and I have to have humour in life but no matter how strong we are at times we all need support Im blessed with a daughter I miss at college and I feel life is flashing by so I hope this info helps : ) take care keep safe in snow and warm and rest when need it, do what your body tells you too and dont mask with all these opiate pain k as given years ago lead to addiction I didnt know what they were so lots of neglect too....if anyone had hip replaced plse tell me its as good as new as Im waiting and its so so so painful? thanks : )
Thank you for sharing this it brings things into perspective I think. It's been a little soul destroying at present and my anxiety levels have been high. I am managing but it's these moments which catch me by surprise and overwhelm my emotions. It hank you and if you ever want to chat please feel free to email me
I was first diagnosed with depression about 20 years ago, and initially tried a couple of older style medicines which basically turned me into a zombie, which was no good since I was a single mother with a young son to care for. The next drug was sertraline, which I took on and off over all those years, with no side effects at all, and it really helped me....until the next time I needed it when I would request it. More recently I have been taking citalopram, which is the same sort of drug, and again with no side effects, though I do feel that the sertraline was more effective.
I also taking Amitripline, The dose i am taking now is 35mg, i started of with 10 then 40 then 50, I'm now slowly starting to reduce the dose down, found it really helps me to get a good nites sleep, which i believe helps with depression, I don't know where i would of been without this, differently speak to you GP...
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I finally gave in and gave sertraline a try once my GP convinced me it was just to help with pain and sleep. It did make a difference but I came out in a rather fetching rash so it was changed to amitypryline and so far so good. My sleep is still disturbed but a bit deeper and pain seems to be getting a bit better too. Still totally barking though x
Combinations 
Tentatively optimistic mtx working!
I step forward, 2 step backward!!!
