I don't know how useful this info. will be and for who, but I recently started taking mytelase, by my neurologist's recommendation based on some observations that it may be better than mestinon in MuSK, and at least for now, this seems to be the case for me.

I don't have any good explanation for this, but as opposed to mestinon (which I stopped taking due to its hechtic effect on my illness) it has a much more stable and predictable effect.

It is longer acting and has a somewhat different mode of action than mestinon. For some reason mestinon is preferred by most neurologists (in fact none of my previous neurologists ever mentioned mytelase or suggested trying it).