I would like to add that if you are going to journal, please write the time that the symptoms occur and what were you doing before the incident.
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Too much" Mestinon gives me eye problems, including tense muscles around my eye and double vision. There was a time when I wanted to stop taking Mestinon, but have found that instead I take smaller doses and sometimes reduce my daily amount. Mestinon definitely helps me but too much Mestinon is worse in my opinion that not enough. It took a long time for my neuro to agree to let me vary the amount of Mestinon but since I started adjusting the amount depending on how I feel, I rarely get double vision.
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I agree that taking too much Mestinon gives me eye problems, especially when my day is a low energy/low stress day, and does not require the medication. As a result, I would have twitching, blurriness, but I would not have double vision or pain.
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I had thought that the pulling feeling in my eye came on when I was weakest, in the late afternoon and evening, but now I think that was a coincidence. That's the time of day the Mestinon is piled up (I was taking it at 9, 12, 3 and 6).
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I'm not a doctor, but if you are taking 60mg every three hours that might be too much. I know it would be for me.
Plus, it took a couple of months to get use to Mestinon. I was happy as a clam at 30mg every eight hours, until I was told that I would need to increase the dosage.
That increase was too much too soon, and I woke up one night unable to move a limb. In fact, I was having the serious adverse reactions, and it took a lot of deep thinking to convince myself to consider giving the medication another try. However, I couldn't breathe at night, so I was really under the gun, but now I know Mestinon better.
At the RIGHT dosage AND at the right TIME, it can be a great benefit.