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6 |
The “results were equivocal” with the exception that there were fewer reactions than with neostigmine. However, a low dosage of pyridostigmine was used (30 mg). This “trial” was only cited in 1954.77. Tether JE. Mestinon in myasthenia gravis (preliminary report). Dis Nerv Syst. 1954;15(8):227-31.
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Schwab et al., 194855. Schwab RS, Timberlake WH. Pyridostigmin (Mestinon) in the treatment of myasthenia gravis. N Engl J Med. 1954 Aug;251(7):271-2. https://doi.org/10.1056/NEJM195408122510706
https://doi.org/https://doi.org/10.1056/...
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(English)
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10 |
No better than neostigmine. No unfavorable adverse event. The pyridostigmine dosage was the same of the neostigmine. This “trial” was only cited in 1954.55. Schwab RS, Timberlake WH. Pyridostigmin (Mestinon) in the treatment of myasthenia gravis. N Engl J Med. 1954 Aug;251(7):271-2. https://doi.org/10.1056/NEJM195408122510706
https://doi.org/https://doi.org/10.1056/...
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5 |
Pyridostigmine had advantages over a previous treatment with neostigmine: first and foremost, it was more effective and tolerated with no side effects, especially in high doses; and, second, also had a prolonged duration of its effect with physical rest. |
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23 |
Favorable experience. The effect is more intense and lasts longer. Side effects only occur rarely on and keep within tolerable limits. Therapy started in 1948 for some patients. |
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5 |
The longest duration of the action offered one advantage over neostigmine. The good tolerability of the drug allowed an increase in the required amount without the threat of side effects. Experimental pharmacological tests, comparing neostigmine and pyridostigmine, on the phrenic diaphragmatic nerve and on the masticatory muscles of the rat supplemented clinical observations. |
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20 |
The effects of pyridostigmine were indicated by examples (reported in few patients) based on clinical and experimental observations. Pyridostigmine was enough to make the patient adequately treated, but the optimal effect was reached only after about 1 hour (greater latency than for neostigmine). |
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Schwab et al., 195455. Schwab RS, Timberlake WH. Pyridostigmin (Mestinon) in the treatment of myasthenia gravis. N Engl J Med. 1954 Aug;251(7):271-2. https://doi.org/10.1056/NEJM195408122510706
https://doi.org/https://doi.org/10.1056/...
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(English)
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50 |
20 patients found the drug superior to neostigmine. “Large” individual doses were used. The “antimyasthenic effect” was calculated as one fourth of the equivalent amount of neostigmine. |
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Osserman et al., 195466. Osserman KE, Teng P, Kaplan LI. Studies in myasthenia gravis: preliminary report on therapy with mestinon bromide. JAMA. 1954 Jul;155(11):961-5. https://doi.org/10.1001/jama.1954.03690290011004
https://doi.org/https://doi.org/10.1001/...
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(English)
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20 |
15 patients found pyridostigmine more effective than neostigmine. Side-reactions were absent or so diminished that the use of atropine could be stopped. |
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Westberg et al., 195488. Westberg MR, Magee KR. Mestinon in the treatment of myasthenia gravis. Neurology. 1954 Oct;4(10):762-71. https://doi.org/10.1212/WNL.4.10.762
https://doi.org/https://doi.org/10.1212/...
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(English)
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22 |
21 patients preferred pyridostigmine over neostigmine. The duration and maintenance of effect was longer. Side effects were mild. |
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56 |
Neostigmine and pyridostigmine provided relatively equal control of “myasthenic symptoms.” Pyridostigmine provides smoother and a more sustained control of symptoms. Untoward reactions are less frequent and less intense. No toxicity was noted. Pyridostigmine was less desirable than neostigmine, because it has a slower onset of action. |
