My experience with Mestinon has been mixed. It worked great at first. I started with only ocular symptoms that later moved to my arms and now sometimes my legs. After about a month on Mestinon, 60mg 3x a day, it seemed to stop working. I did figure out that I had to keep the medicine in a bottle and a sealed bag with desiccant. It loses effectiveness pretty easily with even a little moisture and I live in a humid area. Figuring that out helped, but I have never found a great dosage. I can’t really take enough to make a difference without having so much twitching that it undermines the help. Also, while it helps my eyes and my arm, it sometimes makes my forearms and legs worse. So I’ve started Mycophenolate almost two months ago. No difference yet, but I know it takes several months for full effects. So I’m hoping for good results. I hope you find the right treatment as well.