I find I easily loose the steady hand now. I am easily affected by medication (like allergy meds), caffine, and so forth. I don't know if it has to do with meds (I take only plaquenil regularly now and nexium) or from other issues. I easily get jittery as well.
I never had this problem before. I'm trying to remember if I had that problem w/methotrexate...I had so many issues on that medication, I can't remember for sure. It's been 3-4 years now.
The fact you are suddenly very tired makes me think you are getting sick or in a flare. I think I suggested in another post about upping your B vitamin/folic acid intake. I would also make sure you get in your monthly labs (if your liver is starting to react to the medication, that will make you extremely fatigued.) I know you have insurance issues, but soon as you can, get a check up and discuss this with your doctor.
Good luck. ***