Hydroxychloroquine vs sulfasalazine vs methotrexate experiences?

Hydroxychloroquine doesn't require labs but I hope you have been told all about the annual eye exams that are needed. That's the most important part about the treatment. I have taken it for several years at a time with breaks. I live with Sjogrens Disease and Rheumatoid Arthritis. Like you I have tendonitis, bursitis, etc. I have always had Hypermobile Ehlers Danlos which causes injury to muscles because of over-extension.

I found that it helps me most with the Sjogrens symptoms: dry eye, dry mouth, joint pain and fatigue. I think it takes a few weeks to feel the effects.
I can't take methotrexate. I had such deep depression on that one that I quit it.

@yellowfleurs sulfizalazine is by far I think the best . I have auto immune illness and it's worked great so far for me!!! I hope you figure out the best option for you!!!

Do you have a diagnosis or potential cause for the tendonitis.
It can be associated with axial arthritis and not always seen on
X-ray. There are no definitive tests for certain arthritides.
Is there a family history or any associated skin problems?

@seniormed It started suddenly when I was 17 without known cause but a few years later I was diagnosed with Lyme disease and treated. Then I got gastroenteritis and with it a major flare plus urinary symptoms and I was told seemed I had reactive arthritis. My symptoms improved but never went away and I have since developed additional immune type symptom during flares. My rheumatologist thinks I have seronegative spondyloarthropathy, but the peripheral kind or maybe post treatment Lyme disease syndrome. I have had SI joint pain for years but even MRIs are normal there. I don't seem to have spine issues.
I have rosacea, seb derm and eczema, but no known psoriasis. I am getting very slight nail pitting among other changes recently so I am keeping an eye on that. No family history. Thanks for the response!

@bosslady38 Thanks for the reply! I am glad it works well for you! If HCQ doesn't go well I have been thinking sulfasalazine will be next. Did you get any side effects?

@jw9 Thank you! Yes he told me about the eye exams. It does worry me a bit but I guess they all have some risks. That is good to know it helped with those symptoms!
I have had doctors ask me about hypermobility over the years but I think my issue all started with this inflammation that I have had for so long it is damaging my tendons (never had problems as a kid that I know of).

I have Sjogren's Disease and Lupus and I started HCQ last April 12th 2025 and after approximately 2 and 1/2 months I noticed a lessening of pain from Sjogren's Disease. However, as time went by I noticed that I was becoming very anxious. On September 14th 2025 the anxiety was so severe that I stopped taking HCQ. This medication has a long half life when it is in your body so it can take up to 50 to 60 days for it to completely leave your body. Somewhere between 50 to 60 days the anxiety started to fade. This was probably the worse experience in my life as I couldn't be alone because of sheer terror. I felt as though I had an psychotic episode and would never be the same person as I previously was. I saw an extremely experienced acupuncturist who helped, I practiced acupressure, I sat on my elliptical for one hour a day, I took one drop of a mild marijuana tincture and slowly I returned. That was a nightmare. I have a corneal specialist that I see at Mass. Eye and Ear Boston and she told me that only one of her patients actually became totally blind after taking it for an exceedingly short time ?3 to 4 months perhaps. Hope this information helps you.

@dianedonohue Sorry if that info was depressing but it is important to know of all possibilities when taking these very powerful medicines. HCQ gets absorbed by all tissues in the body that is why it can cause blindness. Good luch on your journey.

@dianedonohue thank you for letting me know! So sorry you experienced that. I have a bad track record with meds actually so am always pretty cautious. I'll probably stop quickly if I'm feeling my mental health shift especially after the initial adjustment period. I also started on half the dose I'm supposed to get up to since I'm sensitive and want to make sure I do okay. I avoided the steroids for a bit for the same reason but surprisingly that went really well so I'm hoping this goes better than anticipated.

@yellowfleurs I am glad it was helpful and not depressing. I thought it was important to respond because there could be someone out there that is on that medication that has been diagnosed as mentally ill and it's probably the side effects of Hydroxychloroquine!