Effects of Pyridostigmine on Psychomotor and Visual Performance

Pyridostigmine is a reversible anticholinesterase inhibitor long used in the medical treatment of the neuromuscular disorder myasthenia gravis. Due to the site and the reversible nature of its action, this drug is currently being considered by the USAF for field use as a pretreatment medication to aid pilot survival in the event of a chemical attack. Medical reports indicate that high daily oral doses 600 mgday are well tolerated in patient populations. Recent NATO studies also suggest that lower dose regimens 30 mg, 3 x day, 30 days can provide enhanced survival protection in nonclinical populations, with only minor gastric upset reported in a few individuals. Although health risks appear minimal, there exists a significant need to evaluate the impact of the drug on human functions important in pilot operations. The present study addressed this need. A double-blind, cross-over experimental design was used to evaluate the effects on oral regimen of pyridostigmine 30 mg, 3 x day, 5 days on the performance, physiology, and subjective state of 24 paid, male volunteers.