Methotrexate or Cyclosporin?

[rinbag]

Hi guys - I'm new here. My dermatologist has asked me to research online, so I'm going for it...

Basically, I'm 25 and I've had psoriasis since I was 11. It has gradually got worse since I've got older and I have it on most parts of my body - mainly my scalp at the moment which is VERY annoying (as I'm sure you'll all agree). I've pretty much used every cream and ointment I can think of and apparently I've used to much steroid cream now. Last year I had PUVA treatment which I was really responsive to, but my psoriasis came back within a matter of months and obviously my scalp didn't clear up at all because of my hair being in the way.

Anyway - my dermatologist has now given me the option of taking Methotrexate or Cyclosporin. I think I'm leaning more towards the Methotrexate purely because the results would be more long term, but I was just wondering what everyone here would suggest? It's all pretty scary and I've got to make a decision by the 17th.

Any advice would be great! Thanks!

[Guy]

Hi there.

I am currently on Methotrexate and have been since Feb last year and before that I was on Cyclosporin. 
My opinion is that Cyclo is a lot heavier on the body than MTX - I certainly felt rougher on Cyclo and seemed to have a cold all the time.  MTX makes me feel tired for a couple of days after the day I take it but I have become more accustomed to these side effects.
My derm also was comfortable for me to stay ON MTX as long as my body is handling it.  I have blood tests every 6 weeks.

Both Cyclo and MTX have given me almost 100% clearance.

Having said all of this it does seem to be the case that we all resond to different medications in different ways.

But my advice would be try MTX first.

Good luck.

Guy 

[rinbag]

Thanks for you reply 

Yeah the Cyclosporin looks pretty tough to be fair. My derm said something about not being able to have children for 2 years after taking it? A tad frightening.

Okay well... I guess I can always try the Methotrexate and see what happens.

Thanks again.

[arizona]

Try mtx and if no good go onto the ciclo?

mtx didnt suit me but ciclo was brilliant. Though derms are happier to leave you longer on mtx , its slower to take effect but if it suits you then isnt as toxic as ciclo. Saying that though, dont be worried if you do need to change to ciclo it was life changing for me for a few years and if i could i would go back on it. A few weeks tiredness followed by feeling great and clear skin 

Either way one of them is likely to give you a better year this year 

[MULLINDE]

You don't have to make a choice between just those two.

Ask you Derm about the possibilities of Acitretin (orry about the spelling) and Fumaderm.

I was offered all of those and, after a very quick encounter with Acitretin, (OK if you are teetotal) I am very glad that I am on Fumaderm.

Anyway, let us know how you get on.

Daryl

[Luvvi]

I've been on both, Ciclo on its own, then in combination with MTX (worst time of my life ugh) then just MTX unfortunatelymy bloods were effected very quickly and I had to come off it.

Depending on how severe your psoriasis is some Derms will suggest you go on Ciclo first to achieve some clearance, Ciclo tends to work more quickly than MTX, then introduce the MTX and reduce the Ciclo.  If I had to choose between the two I could go for MTX on its own. 

Good luck with whatever you choose.....let us know!

[lilactime]

i was in your position and choose cyclosporin purely based on the fact i like the occasional drink ! 3 months in and im 95% clear just a few spots that im hoping will go in time . blood tests now at every 8 weeks and so far been fine . as for the side effects ive had none in fact ive had less colds since ive been on it ! may have had some tiredness but this could be put down to work/exercise . i realise that one day i will be brought of it , then i will consider one of the others . by the way if you took note of all the side effects listed on a box of paracetamol you wouldnt touch them ! whichever you choose good luck !!