Mestinon is being used now for severe autonomic neuropathy/dysfunction. The Mayo Clinic discovered and implemented this use a few years ago as the drug causes muscle contractions and this can help increase BP in those with orthostatic hypotension.

I was given a trial of this last year since my autonomic neuropathy is quite severe...as has been for many years. My BP can drop into the 60's after standing, even though I take Midodrine and Florinef.

Sadly, I never really got a chance to find out if this medication would have worked because it caused asthma attacks within 20-30 minutes of taking the drug. This is a rare, but serious side-effect/reaction. It caused bronchial spasms, but since I already have asthma, it sent me into an attack. I thought it was a coincidence the first time it happened, but after the second time I figured it was the medicine. I stopped and waited until another day and tried one last time...sure enough, another asthma attack (quite severe too).

But others have had good results with this medication, so don't discount it based upon my experience. But if you have asthma, be aware as it will increase your risk of a problem with bronchial spasms. I also had some muscle twitching, but it wasn't anything profound.