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Pyridostigmine Bromide and Constipation in Parkinson's Disease

Kamal Sadjadpour, MD
JAMA. 1983;249(9):1148. doi:10.1001/jama.1983.03330330030012.
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To the Editor.—  It is well known that in Parkinson's disease, motility of the bowels is severely impaired in conjunction with reduced motility throughout. In patients who have advanced Parkinson's disease, severe constipation is often a major problem. This constipation is not sufficiently responsive to bulk laxatives, since such laxatives do not have a direct effect on intestinal motility.I have used pyridostigmine bromide for a number of years for patients who are not relieved by ordinary measures used against constipation. This drug, which is used in the treatment of myasthenia gravis, enhances intestinal motility and may in fact produce diarrhea and abdominal cramps in some patients and in large doses.I have not encountered any adverse effect on Parkinson's disease by use of this drug. No interaction with other drugs used for the treatment of Parkinson's disease or reduced effectiveness of such drugs has been observed. The dose of


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