[Thyrostatic drug therapy of Basedow disease. Combination with thyroid hormones and/or beta blockers]

Basing on the results of the European and Austrian survey on the management of hyperthyroidism due to Graves' disease the theoretical backgrounds of the combination of thyrostatic treatment with thyroid hormones and with beta blocking agents are discussed. A suspected lack of compliance of a hyperthyroid patient is probably the only strong argument for the use of combination therapy with thyroid hormones. Some countries in Europe prefer this way of treatment, whereas other countries decline it. In Austria the opinion of the necessity of thyroid hormones in thyrostatic treatment is also not unanimous, the majority, however, preferring it. In contrast, the supporting use of beta blocking agents especially in highly symptomatic patients stands beyond debate. However, monotherapy with beta blockers for preparation of subtotal thyroidectomy in hyperthyroid patients is generally declined, probably because of the danger of a postoperative thyrotoxic crisis. Most colleagues agree (as well in Europe as in Austria) that the combination of thyrostatic drugs with beta-blockers is the best choice for the preparation of subtotal thyroidectomy, saving time and thereby costs and reducing the danger of a postoperative thyrotoxic crisis.