I get mental effects from the MG and the Mestinon, too.

When I get tired and weak from MG, my mind is a little slow, mostly the speaking part. I feel fine mentally until I try talking to someone. It is hard to explain...I have trouble finding all the words that I want to say, but this only happens when my MG is bad. I also have a hard time making decisions when my MG gets bad, even simple decisions.

About 20 minutes after I take Mestinon, I get a nervous feeling and avoid having conversations because I can't speak clearly, skip words and talk too fast...kind of like I drank way too much coffee. This isn't very noticable with the 15 mg dose, but when I was taking more I avoided people and would not answer the phone during this time. I felt like I was having some kind of panic attack, with a rapid heartbeat...this is why I dropped my dose to 15 mg...I started to feel nervous about taking Mestinon at this higher dosage and skipped doses sometimes and instead went to bed.

I have found that the Mestinon works best for me mentally if I relax for 30 to 1 hr after taking it, and have quiet time to myself.

Something else that seems to help...seems sort of silly, but I will type it anyway just in case it helps someone else...after taking the Mestinon I imagine how the Mestinon is helping me, and sometime even close my eyes and visualize myself having more energy and having stronger muscles, and this really seems to help. I don't want to imply that MG is all in my head (or anyone's), because obviously it isn't, but that our minds can help in the healing process somehow.

Vitamin B-12 helps with the mental tiredness for me.

I hope some of this is helpful.