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Afraid? Are you kidding me?? I was terrified! When my rheumatologist first suggested methotrexate, I went home and thought about it, which for me includes research on the Internet. And then I whimpered and stuck my head in the sand for a couple of weeks.   When your doctor suggests the big scary drugs, you have to weigh the pros and cons - how much does your RA limit you, how big is the risk of your joints becoming damaged - as well as think long-term. These drugs not only help you function better in your present day-to-day life, but they extend the life of your joints and delay damage. Depending on your current levels of function, damage, pain, fatigue, etc., you may notice the moderate to huge improvement if you start taking the drugs.   In terms of the side effects, many are reversible (i.e., when you stop taking the medication, the side effects stop, as well). Some aren't and they are usually the more serious ones, but they are also more rare. Taking a look at the numbers may be helpful. Let's say 2% of RA patients taking methotrexate develop liver damage (I couldn't find the actual number in Google, so that's a pure guess - your doctor will be able to give you the accurate number). That means 98% of RA patients taking methotrexate do not develop liver damage (again, 98% is a theoretical number). Sometimes, if you flip it, your perspective changes and the fear lessens.   I am not arguing that you should start Methotrexate or Enbrel - only you can decide that after carefully weighing the risks and benefits. But keep in mind that your decision that is reversible - you could take one of them for a test drive to see how you feel. If you think the improvement is worth it, you may decide to continue. If the improvement isn't significant, you can stop. That's how I talked myself into starting methotrexate and for me, the reality turned out to be nowhere near as scary as what my imagination cooked up. Talk to your rheumatologist again about your fears and concerns - information is power and having all the information, although initially a little scary, can help you make a decision that's right for you.