Lithium carbonate in the preoperative preparation of Graves' disease

Lithium carbonate was given in the preoperative preparation of 12 patients with Graves' disease, the reasons for its use being side effects of thionamide in 9 patients, insufficient control by thionamide in 1 and psychic symptoms in 2. Lithium carbonate was often used in combination with other drugs, namely; thionamide in 4 patients, beta-adrenergic blockades in 5, reserpine in 5 and glucocorticoid in 1. This preoperative control significantly decreased the mean serum T2 and T4 levels from 656 +/- 55 ng/dl to 180 +/- 16 ng/dl and from 25.9 +/- 2.1 micrograms/dl to 9.7 +/- 1.5 micrograms/dl, respectively. The only adverse effect of lithium carbonate was pollakisuria observed in one patient. All patients underwent subtotal thyroidectomy uneventfully. It is concluded that the administration of lithium carbonate alone or in combination with other drugs is an effective method of preoperatively controlling hyperthyroidism when conventional antithyroid drugs show adverse effects.