Some of us can't give up on attaining Mytelase. It is the only drug that works for us. I don't know the reason why Mestinon doesn't work but it never has. In fact, Mytelase has always been more expensive and harder to attain. I would not switch to it if you aren't currently using it. If you are using Mytelase then we have a problem. Right now I am working on attaining it from the DEA or maybe France, if necessary. The drug company doesn't have to allow anyone new to have the drug but those of us who have been using it for years should have access until we die. It seems like the ethical thing to do. As we "oldies" expire then the drug will no longer be available to anyone. But you can't just discontiue it in mid stream. I will have to go back on a respirator full time and not be able to swallow or talk. So the effects for me are severe. I may be able to walk a little and use my arms for part of the day but nothing else works. I know this from past experience. Times are tough.