In low doses these drugs do not act as an anti-depressant but have beneficial effects on sleep pattems and can help reduce pain. The most frequently used drug is amitriptyline although there are many different ones available. Long-term treatment with drugs can cause problems to the joints and muscles. The most well known problems are with the steroids. Steroids over a long period of time can cause thinning of the bones, osteoporosis, and increase the risk of fractures.
Steroids can also have effects on the muscles causing weakness and a similar condition to myositis.
Steroids have also been linked to a condition called avascular necrosis of bone. The only treatment available for avascular necrosis is joint replacement. Doctors are more aware of the problems of steroids than in previous years and try to keep the dose of steroids low enough to keep the lupus under control but reduce the occurrence of side effects. Some of the other drugs used in lupus can have effects on the joints and muscles including methotrexate and cyclosporin but these effects tend to be rare. Some of the material is repeated on several sheets.