An Update on the Mestinon Clinical Trial

From the Open Medicine Foundation

In May, 2020, Open Medicine Foundation (OMF) announced the Mestinon Clinical Trial for ME / CFS, conducted at the Brigham & Women’s Hospital by Dr. David Systrom in association with the Harvard ME / CFS Collaboration at the Harvard Affiliated Hospitals.


This study was started after Dr. Systrom observed that some people with ME / CFS have what is known as Preload Failure (PLF).

In this instance, Preload Failure is thought to come from an imbalance in the autonomic nervous system and results in reduced filling of the heart during exertion, and could be associated with postural orthostatic tachycardia syndrome (POTS) and / or post-exertion malaise (PEM).

Prior studies have shown symptomatic improvement in the general population with PLF after treatment with Mestinon.


Dr. Systrom and his research team are now conducting a clinical trial on the therapeutic effects of Mestinon: “The Exercise Response to Pharmacologic Cholinergic Stimulation in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome.”

To understand the effects of Mestinon, Dr. Systrom utilizes an invasive cardiopulmonary exercise test (iCPET), which measures the blood flow, vascular pressures, and ventilation and gas exchange in the lungs and skeletal muscles during exercise.

In this study, patients perform an iCPET, and take either a 60 mg tablet of Mestinon or placebo, and perform a second iCPET assessment 50 minutes later to assess for any improvement of various exercise parameters.

By investigating the link between the autonomic nervous system and the dynamics of blood flow in people with ME / CFS, we are hopeful that this will lead to new targeted treatments and a deeper understanding of ME / CFS.

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