An evaluation of lithium as an adjunct to carbimazole treatment in acute thyrotoxicosis

The rate of control of thyrotoxicosis during the first 2 weeks of treatment was documented in 63 patients. Twenty-three patients received carbimazole 40 mg plus lithium carbonate 750 mg daily and a comparable group of 20 patients were given carbimazole 40 mg plus potassium iodide 120 mg daily. In the lithium treated patients the mean percentage fall of serum T4 after 2 weeks treatment was 49% and the fall in serum T3 57%. The results were similar in the iodide treated patients; the mean falls in serum T4 and T3 being 47% and 64%, respectively. Serum lithium values varied between 0.1-1.25 mEq./l; lithium side effects were minor. In a companion study 20 patients were treated with carbimazole alone. The responses in this group were less impressive; the mean falls in serum T4 and T3 at 2 weeks being 18% and 36%, respectively. It is concluded that lithium is a safe adjunct to conventional antithyroid drug therapy in the initial treatment of acute thyrotoxicosis.