This column describes the author’s own experiences with pyridostigmine bromide. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.
A little-known fact about yours truly: When I was enlisted in the U.S. Army as a combat medic, I was studying to go to medical school with the intention of pursuing medical research. It’s a passion of mine.
Sometimes when my health throws me a curveball, as it has now, and keeps me awake for 24 to 30 hours and sleeping for up to 17 hours, I do something crazy like read random medical journals and dive deep into research mode.
After recent discussions in a couple of support forums and groups, I decided to take a deep dive into how pyridostigmine bromide (known by the brand name Mestinon) became the front-line treatment for myasthenia gravis (MG).
The basics: What is pyridostigmine?
Pyridostigmine bromide (I’ll call it PB for short) is a little pill that helps muscles hang on a bit longer to the messages that travel from nerves. It keeps the muscles’ gates open longer so those messages can get through. It’s also a medicine with a generic name that will get you the eyebrow raise from just about every nurse or doctor you see when you can pronounce it right — and better than they can.
PB is a treatment for MG, not a cure. Its origins stem from nearly 100 years ago, in 1934, thanks to the work of one Scottish doctor, Mary Broadfoot Walker. While working as a medical officer in London, she noticed that symptoms of soldiers poisoned by curare and those with MG were quite similar. She used the antidote for the poisoning, physostigmine, on an MG patient; the results spoke for themselves.
It wasn’t long before neostigmine, created a bit earlier in 1931, was used in place of physostigmine because it was more stable. A few more years down this road of MG history, and we find a pair of Swiss chemists who in 1945 developed pyridostigmine, which is in use today.
Why the lasting power?
It’s difficult to come to terms with the reality that there’s no cure for MG. We have treatments. Some of them suppress the immune system to reduce the overactivity. Other treatments, like PB, help. It’s like using a ramp instead of the stairs. The stairs are still there, but the ramp makes access easier.
PB acts fast and is relatively safe for most people who have MG. Some people who take it have belly issues and have to take something for diarrhea. I’m lucky in that area; I have no adverse reactions. It simply helps me live a better life.
Every morning I take one of these little pills. I set the timer on my watch for four hours so I don’t forget to take my next dose. Within 30 minutes of taking it, I feel stronger: I can go for that swim, eat a meal without choking, and laugh at some silly eye-rolling joke my husband has made.
PB is truly a miracle drug, and I’m thankful for the medical professionals who questioned and sought answers for the patients they treated. Medicine is a practice. Without the constant work and diligence of Walker and others, who knows where things would be with the treatment of MG today?
Note: Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Myasthenia Gravis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to myasthenia gravis.
