Re: RESEARCH - Central nervous system toxicity associated with weekly low-dose MTX

[Guest guest]

I KNEW IT!!!

Stan

-------------- Original message --------------

From: <Rheumatoid.Arthritis.Support@...>

Arthritis Rheum. 1989 Jun;32(6):770-5.

Central nervous system toxicity associated with weekly low-dose

methotrexate treatment.

Wernick R, DL.

Providence Medical Center, Portland, OR 97213.

Central nervous system (CNS) toxicity from low-dose methotrexate (MTX)

has been reported rarely, and reported symptoms consist primarily of

dizziness and headache. We reviewed the records of 25 consecutive

patients treated with low-dose MTX, and found 5 who had spontaneously

reported unpleasant cranial sensations, mood alteration, or memory

impairment. Rechallenge with MTX on 5 occasions in 3 patients led to

recurrent CNS symptoms in all cases. CNS toxicity was the sole reason

for discontinuation of MTX in 2 patients. These 5 patients differed

from the 20 without CNS toxicity in age (mean 68 versus 50) and

baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not

in weekly dosage of MTX (12 mg versus 16 mg). These results suggest

that CNS toxicity is more common than previously reported,

particularly in older patients with mild renal insufficiency.

PMID: 2735964

http://www.ncbi.nlm.nih.gov/pubmed/2735964

Not an MD

[Guest guest]

Stan,

A caution in interpreting this study - it's very old, and we don't

know if the subjects were also taking folic acid.

Not an MD

On Fri, Jan 23, 2009 at 11:51 AM, <stanpfister@...> wrote:

> I KNEW IT!!!

>

> Stan

>

> -------------- Original message --------------

> From: <Rheumatoid.Arthritis.Support@...>

> Arthritis Rheum. 1989 Jun;32(6):770-5.

>

> Central nervous system toxicity associated with weekly low-dose

> methotrexate treatment.

>

> Wernick R, DL.

> Providence Medical Center, Portland, OR 97213.

>

> Central nervous system (CNS) toxicity from low-dose methotrexate (MTX)

> has been reported rarely, and reported symptoms consist primarily of

> dizziness and headache. We reviewed the records of 25 consecutive

> patients treated with low-dose MTX, and found 5 who had spontaneously

> reported unpleasant cranial sensations, mood alteration, or memory

> impairment. Rechallenge with MTX on 5 occasions in 3 patients led to

> recurrent CNS symptoms in all cases. CNS toxicity was the sole reason

> for discontinuation of MTX in 2 patients. These 5 patients differed

> from the 20 without CNS toxicity in age (mean 68 versus 50) and

> baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not

> in weekly dosage of MTX (12 mg versus 16 mg). These results suggest

> that CNS toxicity is more common than previously reported,

> particularly in older patients with mild renal insufficiency.

>

> PMID: 2735964

>

> http://www.ncbi.nlm.nih.gov/pubmed/2735964

>

>

> Not an MD

[Guest guest]

This is specifically why my doctor removed me from MTX... I was worse at 4 pills

a week than 8 and then even 2 made me feel rotten so we pulled the plug!

****~**** Kami ****~****

Re: [ ] RESEARCH - Central nervous system toxicity

associated with weekly low-dose MTX

I KNEW IT!!!

Stan

-------------- Original message --------------

From: <Rheumatoid.Arthritis.Support@...>

Arthritis Rheum. 1989 Jun;32(6):770-5.

Central nervous system toxicity associated with weekly low-dose

methotrexate treatment.

Wernick R, DL.

Providence Medical Center, Portland, OR 97213.

Central nervous system (CNS) toxicity from low-dose methotrexate (MTX)

has been reported rarely, and reported symptoms consist primarily of

dizziness and headache. We reviewed the records of 25 consecutive

patients treated with low-dose MTX, and found 5 who had spontaneously

reported unpleasant cranial sensations, mood alteration, or memory

impairment. Rechallenge with MTX on 5 occasions in 3 patients led to

recurrent CNS symptoms in all cases. CNS toxicity was the sole reason

for discontinuation of MTX in 2 patients. These 5 patients differed

from the 20 without CNS toxicity in age (mean 68 versus 50) and

baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not

in weekly dosage of MTX (12 mg versus 16 mg). These results suggest

that CNS toxicity is more common than previously reported,

particularly in older patients with mild renal insufficiency.

PMID: 2735964

http://www.ncbi.nlm.nih.gov/pubmed/2735964

Not an MD

[Guest guest]

Well I am not in the older population and don't have any renal

problems but I had severe anxiety from MTX. Good to finally see

something about the CNS besides just me.

>

> Arthritis Rheum. 1989 Jun;32(6):770-5.

>

>

> Central nervous system toxicity associated with weekly low-dose

> methotrexate treatment.

>

>

> Wernick R, DL.

> Providence Medical Center, Portland, OR 97213.

>

>

> Central nervous system (CNS) toxicity from low-dose methotrexate

(MTX)

> has been reported rarely, and reported symptoms consist primarily of

> dizziness and headache. We reviewed the records of 25 consecutive

> patients treated with low-dose MTX, and found 5 who had

spontaneously

> reported unpleasant cranial sensations, mood alteration, or memory

> impairment. Rechallenge with MTX on 5 occasions in 3 patients led to

> recurrent CNS symptoms in all cases. CNS toxicity was the sole

reason

> for discontinuation of MTX in 2 patients. These 5 patients differed

> from the 20 without CNS toxicity in age (mean 68 versus 50) and

> baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but

not

> in weekly dosage of MTX (12 mg versus 16 mg). These results suggest

> that CNS toxicity is more common than previously reported,

> particularly in older patients with mild renal insufficiency.

>

>

> PMID: 2735964

>

> http://www.ncbi.nlm.nih.gov/pubmed/2735964

>

>

>

> Not an MD

>

[Guest guest]

Of course, but as always the information you post is so helpful and the

knowledge is obviously beneficial. I've painted the day after medication as my

down day, and it's never hurts to know the side effects we have to deal with,

plus the knowledge that it's not " something " else going on, it is the

medication. For me, the benefits of MTX far outweigh going without it. Also, I

wanted to apologize to you as the Moderator for recent issues. It was absolutely

not intention to create such a disturbance in the Group and/or make anything

more difficult for you.

Stan,

Seattle, Cloudy.

-------------- Original message --------------

From: <Rheumatoid.Arthritis.Support@...>

Stan,

A caution in interpreting this study - it's very old, and we don't

know if the subjects were also taking folic acid.

Not an MD

On Fri, Jan 23, 2009 at 11:51 AM, <stanpfister@...> wrote:

> I KNEW IT!!!

>

> Stan

>

> -------------- Original message --------------

> From: <Rheumatoid.Arthritis.Support@...>

> Arthritis Rheum. 1989 Jun;32(6):770-5.

>

> Central nervous system toxicity associated with weekly low-dose

> methotrexate treatment.

>

> Wernick R, DL.

> Providence Medical Center, Portland, OR 97213.

>

> Central nervous system (CNS) toxicity from low-dose methotrexate (MTX)

> has been reported rarely, and reported symptoms consist primarily of

> dizziness and headache. We reviewed the records of 25 consecutive

> patients treated with low-dose MTX, and found 5 who had spontaneously

> reported unpleasant cranial sensations, mood alteration, or memory

> impairment. Rechallenge with MTX on 5 occasions in 3 patients led to

> recurrent CNS symptoms in all cases. CNS toxicity was the sole reason

> for discontinuation of MTX in 2 patients. These 5 patients differed

> from the 20 without CNS toxicity in age (mean 68 versus 50) and

> baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not

> in weekly dosage of MTX (12 mg versus 16 mg). These results suggest

> that CNS toxicity is more common than previously reported,

> particularly in older patients with mild renal insufficiency.

>

> PMID: 2735964

>

> http://www.ncbi.nlm.nih.gov/pubmed/2735964

>

>

> Not an MD

[Guest guest]

Thank you, Stan. No need for an apology. You didn't cause any problem.

Not an MD

On Fri, Jan 23, 2009 at 12:38 PM, <stanpfister@...> wrote:

> Of course, but as always the information you post is so helpful and the

> knowledge is obviously beneficial. I've painted the day after medication as

> my down day, and it's never hurts to know the side effects we have to deal

> with, plus the knowledge that it's not " something " else going on, it is the

> medication. For me, the benefits of MTX far outweigh going without it. Also,

> I wanted to apologize to you as the Moderator for recent issues. It was

> absolutely not intention to create such a disturbance in the Group and/or

> make anything more difficult for you.

>

> Stan,

> Seattle, Cloudy.

[Guest guest]

Kami - were you taking folic acid on the days before and after the

MTX?.....Doreen

>

> This is specifically why my doctor removed me from MTX... I was

> worse at 4 pills a week than 8 and then even 2 made me feel rotten

> so we pulled the plug!

>

> ****~**** Kami ****~****