Quote:
Originally Posted by AnnieB3
Mike, I'm glad the appointment went well.
I'm confused about something though. Why Neostigmine, aka Prostigmin? It does the same thing as Mestinon and doesn't last as long. So the chance of it helping your ptosis and double vision (DV) is basically the same as Mestinon.
Usually the only thing that helps some people with DV is Pred or another immunosuppressant. I'm sorry if that upsets you but that's sort of the reality with MG.
You can use gel packs or cold washcloths to improve the eye area, though not too cold.
I would be very wary about taking both of those drugs at the same time. The chance of having an overdose of the drugs will be higher due to that. Too much of Mestinon or Neostigmine and you can have a cholinergic crisis, which is when the drug, not the disease, makes you weaker. Please check with your pharmacist about that! I've attached the PDF on it for you.
I had to point that out. Sorry if that upsets you.
Annie
|
Annie,
it's true that both neostigmine and mestinon are AchE inhibitors, but they do have a somewhat different pharmoacology and mode of action. During my first crisis, the very smart head of ICU that took care of me, gave me IV neostigmine on top of the mestinon, not only to see if I was in a myasthenic vs. cholinergic crisis, but also as he saw the dramatic response I had to it, as an SOS when I started having more severe respiratory symptoms. Thanks to that I was only on the verge of being intubated.
when I was back on the general ward, I had to fight with the neuroloigst (who thought it was not required, and "couldn't" work better then mestinon) to keep on receiving it. The combination of mestinon and injections of neostigmine (which I thought of when I was doing extremely poorly, and pretty much forced my neurologist to recomend) again helped me significantly, a few years later, when my condition significantly deteriorated.
So, I think it is not a bad idea to try this combination as long as it is done with caution and supervision. But, I agree with you that most patients will require some immunomodulating treatment, and there are studies that suggest that it may avoid OMG from becoming generalised.