Posted by kaleidoscope on November 9, 2007, at 11:40:45
In reply to Antidepressants + Arthritis - Relief?, posted by Lonely on November 7, 2007, at 23:51:53
Hi again Lonely,
>the inflammation continues, joints are destroyed and other nasty effects of inflammation?
Antidepressants do not relieve inflammation in rheumatoid arthritis, and will not have any effect on the rate of joint destruction. Antidepressants such as nortriptyline and Cymbalta are used only as an 'add on' treatment to help relieve chronic pain when anti-inflammatory treatment has not provided satisfactory relief. The role of antidepressants in rheumatoid arthritis is very limited.
Methotrexate is the first-line DMARD in rheumatoid arthritis but there are plenty of other options for people who don't respond well to it.
Sulfasalazine is one of the alternatives to methotrexate. Unlike methotrexate, it is not a cytotoxic (chemotherapy) drug.
Hydroxychloroquine may be less effective and is mainly used for mild to moderate rheumatoid arthritis, or as an 'add on' in more severe cases.
New drugs called TNF inhibitors (eg. Enbrel, Humira and Remicade) can be very effective for severe RA. They are given by injection. They can be used alone or in combination with methotrexate. TNF inhibitors are phenomenally expensive - insurance is vital here!
NSAIDs such as naproxen are needed by most people with RA to reduce pain and inflammation. Unlike DMARDs (eg. methotrexate, sulfasalazine, TNF inhibitors) they do not prevent joint destruction.
poster:kaleidoscope
thread:793849
URL: http://www.dr-bob.org/babble/20071104/msgs/794098.html