MTX has been good for me. While it doesn't take care of all the symptoms of PsA, it helps enough that I get worse symptoms if I have to stop it for any reason. I also take a biologic (Cimzia) and NSAID (Mobic) and if I have to stop one of them, I notice it almost immediately. It takes all 3 of these meds to get the full benefits.

The doc started MTX by dosing 7.5mg/week for 2 weeks, then on the 3rd week going to the full 15mg/week. It was recommended to take it at bedtime on Friday, so on the first night, I took it and went to bed. Laying there in the dark, thinking about it (would I have a side-effect??), I think I had a very tiny amount of queasiness. But it never happened again.

After a couple of weeks on it, I had to work a weekend and noticed feeling tired till about dinner time on Saturday, after which time I felt fine (I work 2nd shift). Wasn't till the next weekend I worked that I realized it was probably from the MTX. After a couple of months of this (worked 4 weekends), it never happened again. Didn't notice it if I wasn't working, though.

I have thick hair and didn't really notice any loss, though it wouldn't have shown much, since I always have a lot of hair in the hairbrush (without any thinning). Take 1mg of folic acid every day but MTX day. Have been on it for 5 yrs.

DX: Psoriatic Arthritis, Osteoporosis, Psoriasis
Meds: MTX since Oct 2009, 15mg/week. Cimzia-restarted after 2 yrs away.
Epidural Steroid Injections x8; Lumbar Radiofreq Ablation x2
SIJ Steroid Injection x3; Bilateral Radiofreq Ablation SIJ x9