That is my goal also. Bipolar is my #1 concern, after that preventing as much RA & AS damage as possible. I am on the last resort medicine for Bipolar (Clozaril) and probably more clear headed then ever. My mixture of Lefludomine, Sulfasalizine, Enbrel & Cymbalta have take 50-60% of the RA & AS pain. The fibromyalgia has only flared once in the last 6 months after adding Cymbalta and greatly reducing caffeine intake. I had 3 weeks after my first set of bilateral SI injections where I felt well. 3 week out of 3 years, smh! But after adding Enbrel I feel better, not well but comfortable enough to make it through each day. If someone asked when's the last time you felt 100% my answer would be never. I have fought some disorder or disease since I was 8 months old. 100% doesn't exist for me with or without RA & AS.

I'm about 50 - 60% better than I was. Saw the Rheumatologist PA today, and as I was expecting to hear, this is probably about as good as it is going to get. There is a lot I can not take because of my #1) bipolar disorder & #2) Crohn's disease. It was a long 3 years to get to this point. We had the conversation last appointment (3 months ago) that we could make a change & keep playing with the meds to see if we can get any more comfortable or stay where we are, because we know this combo is doing some good. With all the problems that I have had, I have had to have a serious conversation with myself. I don't think there is anything that will get me 100% pain-free, so I will stay at "comfortable" as it is ALOT better than where I was.

That’s a lot of drugs! Are you OK now on this combo?

Methotrexate did the same as with you plus made me manic (bipolar - on meds). Had to stop, am now on Leuflomide, Sulfasalizine, & Enbrel with Cymbalta.

I couldn't tolerate methotrexate. The side effects got to me. I had stomach issues, mood changes, tired, sad, hair thinning. It was too much. That was over 15 years ago when I first got diagnosed. My doctor put me on Enbrel. I had bad headaches from that for almost 6 months. Almost quit and then it worked. I've had to try other meds over the years, but I'm back on Enbrel. I tried leflumonide last year as an add on, but side effects were awful for me. Hair thinning, nausea, and feelings of sadness. I've decided I'm just staying with Enbrel and dealing with whatever comes my way. Side effects from the meds we take can be so terrible! It does take awhile for these meds to kick in, but you can try something else if you can't get through it.