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Started on Plaquenil at 200mg a day for 2 weeks, and have been on 400 mg a day for a little over a week - which is my maintenance dose. I have been feeling extremely fatigued, but now also am having terrible mood changes and feel terribly depressed at times. I am concerned that if I stop taking the Plaquenil, I will start having more episodes of acute arthritic arthritis - which are terribly painful and usually put me in hospital. I have not been offered any alternatives. I have had scleroderma for approx 20 years without being given any DMARD's.