Pyridostigmine

• Pyridostigmine works through the “facilitation of ganglionic and neural transmission in both the sympathetic and parasympathetic nerves” (Kanjwal et al., 2011). This means that it can help with specific aspects of communication within our nervous system.

• The enhanced neural transmission can be very beneficial! When this medication is tolerated, it has been shown to help individuals with neurogenic orthostatic hypotension, but the tolerance can vary secondary to GI symptoms and side effects (Kanjwal et al., 2011).

• Kanjwal and his team did mention that around 51% of patients who tolerated (could take) the medication experienced positive benefits (2011).

• It seems to be difficult to predict what allows some to tolerate the medication better than others, but hopefully in time we are able to gain more insight to target those who we feel would benefit and seek other therapeutic options for those we believe may experience no benefit or significant side effects (Kanjwal et al., 2011).

Source:

Kanjwal, K., Karabin, B., Sheikh, M., Elmer, L., Kanjwal, Y., Saeed, B., & Grubb, B. (2011). Pyridostigmine in the treatment of postural orthostatic tachycardia: A single-center experience. Pacing and Clinical Electrophysiology, 34(6), 750–755. https://doi.org/10.1111/j.1540-8159.2011.03047.x