Aaron,

Mestinon can't do magic...sounds like your friend was in a similar situation as I was.

I was trying to work and tried taking 1/4 of a pill at shorter time periods (after talking to my neuro, he said is was ok for me to take any size dosage as long as I didn't go over the total amount he recommended per day).

It worked for a while, but MG is a strange thing to deal with. I ended up crashing big time and was unable to work and barely able to even care for myself for about three months last year. I crashed not because of the change in dosage but because i was pushing myself too hard.

Personally, I don't recommend using Mestinon to push oneself when you have MG. I learned that the more Mestinon I take, the harder I am going to crash later on. I haven't been able to return to work since pushing myself too hard last year. I overdid it because the Mestinon made me feel strong...

Going by my own experiences, I'd recommend your friend listen to her body and taking a break when she gets weak. Please don't try to help her push herself even more. MG has a way of punishing us for overworking. What she is experiencing, the sudden dropoff, if that were me, and it was me, would be a sign that I must take a break, not take more Mestinon. I no longer try to push myself or take extra Mestinon to do more (even though my neuro says that is okay, lol) because I was going downhill until I stopped working. Now I may be poor financially, but at least I am not experiencing those sudden crashes.

Of course, all that said, we are all different, and your friend may find help by adjusting her dosage timing (after talking to her doctor).

I replied because I was in a similar position, with people around me expecting the Mestinon to be a miracle cure so I could live a normal life, and work normally, and they were recommending similar things to me as you are suggesting to your friend. I felt pressured...and honestly, I wish I had more people around me that were supportive and could work around my weakness without pressuring me to push myself.

I wish your friend the best. She may find support by joining this forum. I think you should recommend it.

~DesertFlower