Pain Concern
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humira, methoxetrate, citalopram is this a safe drug combination?

My medicine regime widens. Until this horrid diagnosis of Ankylosing Spondilitis I was resistant to taking meds. I am intolerant of many meds and foods. My pharmacist was surprised at my meds regime but I am sure my doctors must know what they are doing? Any comments on the above combination would be welcome.

4 Replies

Hello WhiteDaisy. In what way was the pharmacist surprised? If he had any concerns he should have contacted your doc.


He said that there could be a problem with methotrexate combined with citalopram. I will be having monthly bloods checks.


I know citalopram is a Serotonin based antidepressant as I wanted to try it off label for pain. Unfortunately a side-effect is tinnitus and as I already have that, with bells on so's to speak, I had to give it a miss.

Pharmacists know better than GPs about medicine combinations. I often check with mine just to be sure - like you, I just don't like taking them. Ask the pharmacist if you should get back to doctor about the mix.


I would imagine a huge proportion of people with degenerative and painful diseases are on Antidepressants, so the combination hardly sounds unusual to me. I would check in detail on Cytochrome P450 interactions though, (can't see a specific problem with a very brief look) as these cause a lot more problems than Doctors or pharmacists would have you believe, and both those drugs are involved with a fair few mechanisms of in their metabolism!

I personally have had MANY Antidepressant drugs, including several SSRIs and none of then ever had a 0.001% improvement on pain for me, although they all worked surprisingly well for the depression that the pain brings, so I would say they have helped living a little some of the time but they ALL have lousy side effects of one sort or another, and eventually I have given up on them all when the drawbacks outweighed the benefits for me, (the time-scale for that has varied) and the depression is still there now [I am on none of them (for now!)] but everyone's "mileage" varies with any drug.


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