If the PDF is mostly images... probably not.
You might get lucky and all those images are uncompressed bitmaps, but most likely you'd have to downsample the images and that can have a very bad effect on the images. If they're photos, a small amount of resampling and some JPEG compression won't be too noticeable. If they're screenshots, you're in trouble -- any downsampling or JPEG compression is going to make a mess of them.
Acrobat's PDF Optimizer can tell you where the space is being used and has a fair number of options for resampling/recompressing images.
Is the PDF available anywhere for others to take a look?