Hi All,

I'm writing this post about myasthenia gravis, mestinon (pyridostigmine bromide), and fainting or syncope. I'm not looking for an answer on this, I just want to put the information out in cyberspace in case anybody is looking for it. Since I've got MG I might as well share what I've learnt about it, so this is one more entry. I am a medical practitioner.

I'm a 37 year old male with myasthenia gravis, which unfortunately I've had since I was 18. On the bright side, I'm doing well, hardly taking any Mestinon in the last couple of years. Just some mild ongoing facial weakness. I currently take Azathioprine.

There have been countless surprising things that have happened in my time with MG, some of which I think are unrecognised side effects of Mestinon.

When I was a junior doctor (aged about 24 or 25) I had to spend some time in operating theatres, and I found that I would frequently feel faint and have to go outside to sit down. I'm not afraid of blood, and prior to spending time in theatre this had never ever happened before. I seemed to be able to prevent it somewhat by eating and drinking something before going in there. Obviously I now work nowhere near operating theatres.

I wonder (I'm not sure) if this is a side effect of Mestinon. Given mestinon causes side effects through the parasympathetic (autonomic) nervous system, I think it's possible that it could cause faintness, particularly when it's combined with standing still and wearing gloves, gown, mask etc.

So just in case there are any other doctors out there with MG who are finding that they faint in operating theatres, this may be why.

I suppose some atropine would help.

Some of the other posts I've put on the internet regarding MG or mestinon include:
- Myasthenia gravis and swimming (warning)
- myasthenia gravis, mestinon, and teeth / tooth enamel


Cheers,
D