Hydroxychloroquine is an antimalarial drug that is also used to treat certain diseases like lupus and rheumatoid diseases – it is categorized then as a disease-modifying antirheumatic drug (DMARD). They work to alleviate some of the inflammation in lupus, and importantly modify the immune system to try to prevent any further damage. Many people suffer side effects at first, but if you can bear it, it’s worth fighting through until they dissipate.
I take 400 mg and 200 mg on alternate days. I didn’t see any change in my symptoms with this drug for nearly up to a year, so if your side effects are minimal or nonexistent, it might be worth persevering even if you think it’s having no effect. While it hasn’t had a palpable effect on my pain, I notice that I’m able to function better as a whole compared with before I went on it. The important part is that it does help to decrease further damage to your body by the immune system, so if you tolerate it, it’s a good idea to stay on it even without noticeable effects.
Dihydrocodeine is an opioid, in the morphine family. I used to hold off until I was desperate to take these, but now as things have gotten worse, this is my regular painkiller. I take 30 mg several times a day as needed. Unfortunately it means I had to stop taking paracetamol, as taking the two together (even separating doses across hours) made me extremely nauseous and ill. Soon, I will start to introduce NSAIDs again and see if I can tolerate the two together.
Fluoxetine is an antidepressant, and is a selective serotonin reuptake inhibitor (SSRI). I take 40 mg of these a day for chronic depression, and this medication has made a lot of difference! My mental health has been much more stable since the dose has built up, and I suffer less often from disordered thinking or detachment; if I begin to have self-harm urges, I feel more “in my right mind” and capable of rationalizing the urges and not to give into them. There is a lot of stigma about taking antidepressants, but even though naturally it’s not a cure from mental health issues, it has made the world of difference for me. For some people, particular antidepressants don’t seem to agree with them, but there are many out there to try, to see if any suit you and your needs.
Carbomer gel and eye drops
For my dry eyes, I use eye drops; after my diagnosis of Meibomian gland dysfunction and borderline for Sjögren’s syndrome, I was prescribed carbomer gel, which is thicker and tends to have a longer effect. However, it does blur your eyes for a while after use, so I still use over-the-counter eye drops throughout the day.
I am “supposed” to take nortryptiline at night to help with sleep, but I haven’t taken them for a while. This is for a few reasons, such as not being able to get up in the morning very well, which is obviously not good if I have something on, like uni. So I’m currently untreated for my sleep issues.
Occasionally, more so in the winter, I take a salbutamol inhaler.
For gastrointestinal issues, I also take ranitidine, which is a histamine antagonist, and standard over-the-counter anti-indigestion tablets and syrups.
When my urticaria is particularly bad, I take standard over-the-counter antihistamines.
In the past, I have tried nifedipine for Raynaud’s phenomenon, but as it is an antihypertensive and I have cardiac issues, the side effects are not very tolerable. For this winter, I haven’t cleared yet with my doctor if I’m going to try them again.
Here comes the caveat that I have probably forgotten at least something minor, thanks to the brain fog of lupus! 😛