To the Editor.
—The treatment of myasthenia gravis with pyridostigmine bromide is usually well tolerated. There are frequent muscarinic side effects of this treatment; however, these are minor in relationship to the effects of the primary disease and, therefore, are rarely a cause of treatment failure as the patients are willing to "put up" with the side effects. However, in some patients, the diarrhea, excessive sweating, and salivation are a major problem. The traditional approach has been the use of antidiarrheals and, occasionally, atropine sulfate. The oral preparation is short acting,1 and is not always available, especially in closed pharmacies such as in military hospitals. A more readily available, longer-acting treatment would be of benefit to not only those who have severe complaints of side effects, but also in the majority of patients who experience the side effects without complaint. Recently, we have had the opportunity to try a different
Grogan WA. Treatment of Myasthenia Gravis With Pyridostigminen. Arch Neurol. 1987;44(10):995–996. doi:10.1001/archneur.1987.00520220005002
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