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When I was taking mestinon for my MG (prior to a successful thymectomy) I did also notice that alcohol made symptoms worse. I just tried to avoid it or drink less socially when I did. I’m not sure about other substitutes, but I wonder if less use at once or small doses frequently of THC would still trigger. The only other “solution” I could think of maybe is working with a professional to learn meditation or another mindful skill to help with the anxiety when it comes.