[Treatment of Graves' disease--antithyroid drug therapy]

Graves' hyperthyroidism is thought to be caused by thyroid-stimulating antibodies, which interact with the thyrotropin receptors in the thyroid. In this sense there is no ideal treatment for Graves' hyperthyroidism, yet, according to the pathogenesis of the disease. Therefore, drugs of thionamide which inhibit thyroid hormone synthesis have still been used as the antithyroid drugs widely. However, there are many problems left for antithyroid drug therapy. The author described update considerations to solve these problems faced during the therapy of Grave's hyperthyroidism. Major issues discussed are as follows; 1) Thionamide therapy depending on the severity of Graves' hyperthyroidism. 2) Evaluation of drug effectiveness. 3) Possibility and choice of therapy. 4) Change of therapy from antithyroid drugs. 5) Explanation of antithyroid drug to patients. 6) Side effects. 7) When antithyroid drug should be stopped?