Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 770-775 |
| Number of pages | 6 |
| Journal | Arthritis Care and Research |
| Volume | 32 |
| Issue number | 6 |
| DOIs | |
| State | Published - 1989 |
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ASJC Scopus subject areas
- Immunology and Allergy
- Rheumatology
- Immunology
- Pharmacology (medical)
Cite this
Central nervous system toxicity associated with weekly low‐dose methotrexate treatment. / Wernick, Richard; Smith, David.
In: Arthritis Care and Research, Vol. 32, No. 6, 1989, p. 770-775.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Central nervous system toxicity associated with weekly low‐dose methotrexate treatment
AU - Wernick, Richard
AU - Smith, David
PY - 1989
Y1 - 1989
N2 - 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.
AB - 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=0024334546&partnerID=8YFLogxK
U2 - 10.1002/anr.1780320616
DO - 10.1002/anr.1780320616
M3 - Article
C2 - 2735964
AN - SCOPUS:0024334546
VL - 32
SP - 770
EP - 775
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
SN - 2326-5191
IS - 6
ER -