What should I be expecting after first treatment?

Hi there,

I just recently joined the group. I've had psoriasis since in my teens and was able to have in under control for years until I got pregnant. The shampoo I used on my scalp lost its effectiveness. And now I got diagnosed by PsA 6 months after giving birth to my beautiful baby. It was a craazy long and painful 6 months before the doctors concluded it's PsA. I was hurting in my hips and sciatica (doctors thought it's hormones related to the pregnancy), toes (tripped and had sausage toes), right knuckle/middle finger (became swollen and now i have limited mobility), shoulders/elbow (doctors think it's related to childcare-repetitive movements), stiff neck. I was just in PAIN all over. It was hard to get out of bed and take care of a newborn. I was sent to physical therapist and orthopedist. Then finally, I saw a rheumatologist and confirmed it's PsA.

My first treatment is scheduled at the end of the month as I have to wean my baby off the breast. The thought of weaning him this early depresses me and at the same time I want to get better so I could take care of him.

I guess my question is, what should I expect after the first treatment? I believe the medication is Methotrexate. What is your experience of the drug? Side effects? Will I be able to live a pain free life?

I am so nervous.

Methotrexate will take time before you notice improvement. My Rheumy said it takes between 3-6 months before you can see the full effect. I am only into my 2nd month on it and haven't been pain free yet. I am a lot more mobile but not pain free.

As for side effects, I haven't had any. Some people feel sick and get mouth sores. There are 2 ways to take Mtx, oral pills, or injections. Injections seem to have less side effects.

Hi Chelsea So sorry you have to wean your baby because of this disease. I breast fed my 2 kids for 6 weeks and 5 weeks that's it. Bottle time for them was just as precious. They are both healthy adults now. So back toMTX.

MTX is taken orally or by injection. I myself am on injections 25 mg weekly in conjunction with humira 40 mg every two weeks. I responded well in 4 weeks it can take up to 12 weeks to have a good response. I had flu like symptoms for 2 days every week that took about 4 months to resolve itself. I was flat out on the sofa or in bed. It did resolve itself though and a lot of people do not have any SE's at all. You should arrange to have help with your baby for your first day on MTX. You will be advised to take folic acid daily except for MTX day. I take 5 mg 6 days a week. It is important to take MTX on the same day every week and around the same time. Most people take it at suppertime with food or at bedtime to ease some of the SE's of MTX. You cannot drink while on MTX.

So MTX is classified as a Dmard. Disease modifying antirheumatic drug. It is used as a first line drug against PsA. Other meds may be added along the way to help with your pain and to slow down the progression of PsA.

For myself MTX has been a wonder drug. Because of the type of PsA I have and progression rate I am now on humira and live a relatively pain free life most days. good luck to you

Ugh! I'm so sorry. I'm a relative newbie too. I'm on about my eight week of Mtx and my dosage was just increased since I was not noticing much relief at all. I also have minimal side effects, just more than my average fatigue about 1.5 to 2 days after dosing, and sometimes a mild headache off and on. I eat well and healthily on the day of dosing, and hydrate like crazy. This should help you reduce or eliminate side effects for you too. Everyone is unique though. Mtx takes awhile to notice an improvement anyway. The docs will say 6-8 wks. PsA'rs say even up to 6 months. Again though, do not lose heart, everyone is different. I was very nervous too, but the fears of mtx side effects diminished when I became even more fearful of permanent joint damage and debiliatation. Having a baby is taxing on the joints, and your sleep. You will need to take care of yourself so that you can take care of your baby. Some persons respond extremely well to mtx. Some require a combination of mtx(dmards), and biologics such as Enbrel, and even Nsaid pain relievers that also reduce inflammation. Take very good care of your liver. Liver health is key to living better. Keep in touch. This group is great for support and understanding. Hugs and prayers.

After an unsuccessful 3 month run of Sulfasalazine, I am about to take my fifth weekly treatment of Methotrexate tomorrow. So far, it has done nothing for me (in a positive way), however I am still hopeful that it might. The first time I took it, I felt very ill, like I had a bad case of the flu for the first day, just really tired, bad headache, muscle aches, etc. The next time I took it, it was a bit better, the next time even less side effects. Now, the only real side effect is fatigue (which I have anyway!) and a bit of a headache (which I usually have anyway). So my side effects have diminished drastically from the first time I took it, which is good, but every one is different. I would definitely be prepared to NOT do alot the first day, and be sure to have some help with the little one, as you will need (and want) to get lots of rest. I sincerely hope that it will bring you some relief soon....these things, as we all have found out though, can take some time. Glad you have found all the great people here as they have lots of knowledge and wisdom!

GOod luck to you.

So sorry to hear you're going through this. I'm a breastfeeding mom myself. It sounds like it's breaking your heart to have to wean. Would your doctor be willing to try you on Enbrel instead of Methotrexate? I can get you the information word for word from Dr. Hale's book Medications and Mother's Milk (the go-to book for lactaction consultants and breastfeeding support people), but having spoken with Dr. Hale and his team, I personally got the clearance to breastfeed while on Enbrel, which is molecularly too large to pass into breastmilk. Enbrel (or Humira, or other TNF inhibitors) also has less side effects and you're more likely to feel better while on it than you would on methotrexate.

I hope whatever choice you make, you find some relief soon!

Hi Chelsea,

You have been given some very good advice from some very wise folks. Methotrexate (MX) is where the Insurance companies start, either here or Sulfasalazine, sometimes they add other drugs, biologicals that have less side effects and are able to pinpoint down to the very cell, where they need to go.

I know that you are feeling upset about having to ween your baby so soon, but stopping the progression is most important to you as a Mother, as a Woman and as a human being. This disease can progress before you even realize what has happened, seems it is never diagnosed early either.

I am currently taking Enbrel, had 5 shots so far and already feel a little better, would probably be great but for the storms and cold weather.

We are here for you, we look forward to hearing from you, there is no judgement here, we just want you to get well, we want to hear aboout all the fun things going on with your little one!

I feel your pain, and will talk to you anytime.

Big Hugs,


Thank you everyone for sharing. Reading your experiences makes me feel at ease. While waiting to start my treatment, I've been on NSAIDs. Right now I switched from Ibuprofen to Naproxen. Should I be worried about liver damage too? I've been taking it for almost 6 months. Also 2trees mentioned that you cannot drink while on MTX. Can you drink coffee/caffeine while on it?

Hi Chelsea,

I know that lamb just told someone about NOT using any aspertame (diet sweeteners) at all while on MX. He sent her the reports on it too. It is here somewhere in all of this chatter!! Lamb is our resident genius by the way!

Be sure to always eat when taking Aleve (naporxen) even if it is just a cracker. But I do not know if you can mix them. If we are fortunate, he will be back on and respond to these before too long. trees is right about no alochol! I have heard that is a very bad type of 'sick'!

The comments will go on as more of our family comes on.

I wish you well, and again I am glad you jumped right in! You can always talk to us!

Big Hugs,