Has anyone experienced depression on Sulphasalazine? - NRAS

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Has anyone experienced depression on Sulphasalazine?


I have been on Methotrexate and steroids for 10 years. 9 weeks ago I was given Sulphasalazine awell, in order to reduce steroid use. I am an anxious person, but since being on this medication I have become extremely anxious, with panic attacks and depression. Have come off the Sulfasalazine and am starting to feel brighter. Anyone else has this reaction to this medication?

This disease is hard to manage Isn't it?

15 Replies

Hi Adelaide, yes I had a terrible time on Sulphasalazine about 12 yr ago.

I became so ill I couldn't eat, sleep, stand, even communication became very difficult I kept bursting into tears if anyone asked how I was. I ended up laid up on the sofa as I didn't have the energy to do anything and lost 2 stone in a matter of weeks. The hospital kept doing my bloods and telling me to keep taking them and my body would eventually get used to them.... WRONG.

I eventually stopped taking them and felt better within days, then a few days later the hospital monitoring unit rang and told me to stop taking them. I've never been back on them and take Leflunomide and have steroid injections now (I can't take Anti-TNF treatments).

I agree these diseases are hard enough to manage without severe side effects of medications too.

Hope you've spoken to your Rhumy or nurse about stopping them, these effects could have just been short term or they could have given you something to stop the panic attacks and depression.

Good luck

Beth x


Thank you so much for you prompt answer I am new to this website, but feel it could be very useful to me, The consultant told me to stop the drug and I have.

I have been taking a small dosage of antidepressant before I realised it could be the sulpasalazine. I think I will continue with this until I see the doctor as it has eased the anxiety!

It's really strange (seeing other peoples comments) but I have been taking Sulphasalazine for over 20 years and I have never had any problem at all with it. I still continue taking two tablets twice a day.

I take sulfazalazine and methotrexate i to suffer with depresion and have days where i cant do anything apart from lie on sofa. My consultant tells me it is all part of ra i am taking low dose of anti depressent but fome days this doesnt help x.


Depression is a rare side effect of sulphasalazine ( 1 in 1000 persons is the number that may experience this). info taken from patient information leaflet. hope this helps to clarify.. reducing steroids can also cause slight feelings of depresssions as body adjusts to not having them.( this is temporary!)

conversley steroid use especially at higher doses or when use is started ( oral steroids!) can raise the mood x


I only took Sulphasalazine for 3 weeks - i had to come off it because I got some of the nastier very unusual side effects (swollen neck followed by all over itchy, dark coloured rash). My GP took me straight off it but wanted me to go back on it after the rash cleared to make sure it wasn't part of a virus.

But I realised when I came off it that it had also made me pretty depressed because I had my bounce back to normal afterwards so I begged to be kept off it and was. Shame because it was just starting to take effect on the joints and the inflammation markers had just gone down too but I hated the way it made me feel. It's the only DMARD I've been on so far but has given me a deep fear of the others now! I also got mood swings at first when on Kenalog and recently on Prednisolone but only for the first week and not the same as the deep low of the Sulpha. if it is only 1 in a 1000 I was definitely one such! Hope this helps.

TT x

yes! i had a terrible time on them, i never been so down on them from deppression nightmares the lot, i stopped taking them without telling my gp, but did tell her after a while, she was very understandable. and said i did the right thing. hope you get sorted, and good luck. will xx

in reply to williamhookywalker

Thanks so much for all the answers they have really helped! How long after you stopped did the depression last? I am feeling a lot brighter, but still not great....usually a very positive person!!

in reply to Hidden

it took roughly about a week to notice i was feeling better in myself or there abouts :) im so glad to have been a help to you. will xxx

Hi Adelaide,as 1 newbie to another I honestly can not remember being depressed specifically as a result of taking sulphsalazine - as that was in the last century (c'mon - I only mean the 1980's!!) but I defy anyone living with our 'parasite' of R.A. to say that they've NEVER suffered from depression regardless of NSAID's,DMARDS etc.

My consultant recently informed me that my liver functions must be naturally higher,and the panicky phone call I had from my G.P. 'don't take another leflunomide tablet please - your lft's are inflated' was more a case of him erring on the side of caution (they were at 78) - she said that she wouldn't have worried 'til they were over 100!

Adelaide,you wouldn't be human if you didn't worry what the medical establishment ask us to ingest orally or have injected.All I can really say after a rather solid 25yrs on 1 lot of meds or another is that you know your own body better than anyone else,don't be afraid to ask why this one & not that one etc.Consultants/Drs are only human & I have never met one who actually suffers from R.A. themselves - so how do they know what it's like to be you - and if you don't tell them - with a raised voice if you don't think that they're listening properly,then they won't know.As far as depression goes,for me it really hits me at bedtime,especially since my Dad died & now I have to look after the rest of the family (a last promise made).So I'm prescribed Mirtazipine,an anti-depressant which bhelps me switch off and is a slow release so keeps me going through the day mostly - on a really bad day I have Diazapam too,as I'm off the leflunomide at the mo,I'm on 180mg of Morphine a day,but I also have Oramorph for breakthrough pain - but as we all know the efficacy of amounts of drugs reduces over time but the disease gets worse.I doubt I'll ever get replacements,but it seems like another joint gets affected with every year going by - no surprise that & similar prognoses lead us into depression - the best medicines laughter,family & friends.


Caradog: You make some good points, and the best therapy for depression, no matter how you got it, is family, friends, and happy times, lots of laughter, making new memories.

Adelaide: An antidepressant can help initially, to bring you out of depression, especially if you involve yourself in activities with family and friends.. Invite someone over, go to lunch at a favorite place, etc. Eventually you will realize you don't need the antidepressant. All the best, Loret

I take 6 sulfazalazines per day....and anti-depressants also. The depression has been there for years, and I don't feel like the sulfazalazine made it worse. Sorry to hear about your troubles, though. Sounds like you have good medical care. Hang in there!!

Hi AdelI started Sulfa and dating a new lady at the same time.My nights got nightmares, the depression was obvious.I thought it was sulfa, but when my new Lady went on mission abroad, I felt much better.so the choice was sulfa or a new lady.I choose Sulfa without any hesitation.I feel much better now...


I've just stopped taking it as I was suicidal, I'd seen the Dr for depression/anxiety but none of them suggested it could be the Sulfasalazine. Within days of coming off it I felt better and am now back to normal. I haven't seen the Rheumy yet but the RA is back, I was put on this after Methotrexate caused liver issues and I can't take Anti-inflammatory drugs so no idea where I go from here.

I've just done a search for this exact topic. I've been taking sulfasalazine for 1 month and I feel like I have no energy and can't be bothered to do anything or be around anyone. I've also been really short tempered and have been having blazing arguments with my husband. This is the only drug I can take as we're trying for a baby!

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