Patrick here,
what are you using to reduce your antibodies attaching to you muscle receptors pred or what ?
If nothing then like me where the pred is not working yet the mestinon usage becomes directly related to how you use it up ,high activity quicker to run out and you become weaker.
As I have got out this week and had more activity I first of all thought overdose weaker but I had m=no muscle flutters or eye flutters when I was weaker therefore for me no overdose .
I increased it by mistake when rushed by the gp to his office for early appointment took it before leaving the house .forgot I had taken it when I got to his surgery I took a second 60mg at two ,first at one .then I had to rush to catch neuro at three .my neck was down on my chest since saturday because the gp gave me an antidepressant that interfered .
when the neuro saw me now with 120mg in me no neck droop what a fool I felt excellent all round physical strenght during testing .
an hour later my head was on my chest
agreed to changing to 60mg every three hours .
would not put up with my head on my chest straining every other part of my upper body.went back to accident anf=d emergency new neuro says if that what it takes to keep head up change until we cansee if the pred stops the antibodies occupying the muscle receptors.
if not we may have to try adifferent sreoid to stop the anti immune system releasing so many antibodies that they occupy the receptors for too long for the mestinon to stay arounnd and your muscles weaken.
Thats me