Clinical Endocrinology zyxwvut (1988), 28, zyxwvu 305-314 COMPARISON OF METHIMAZOLE, METHIMAZOLE AND SODIUM IPODATE, AND METHIMAZOLE AND SATURATED SOLUTION OF POTASSIUM IODIDE IN THE EARLY TREATMENT OF HYPERTHYROID GRAVES’ DISEASE E. ROTI, G. ROBUSCHI, E. GARDINI, M. MONTERMINI, M. SALVI, A. MANFREDI, A. GNUDI AND L. E. BRAVERMAN Cattedra di Endocrinologia e Patologia Costituzionale, I’Clinica Chirurgica, Universita degli Studi di Parma, Parma, Italy; Divisione zyxw di Chirurgia, Ospedale S. Maria, USL N.6, Borgotaro, Italy; Division zyxwvu of Endocrinology and Metabolism, University of Massachusetts Medical School, Worcester, M A 01605, USA (Received 30 July 1987: returned zyxwvut for revision zyxwvuts 26 August 1987:Jinally revised 10 September 1987; accepted 14 October 1987) SUMMARY We have evaluated three regimens for the rapid control (10 days’ therapy) of thyrotoxicosis in hyperthyroid Graves’ disease: methimazole (MMI, 40 mg/ day), MMI and sodium ipodate (MMI zyxwv + Na Ipodate, 1 g/day and MMI and saturated solution of potassium iodide (MMI + SSKI, 6 drops twice daily). When serum T4 and T3 concentrations were analysed as the percent change from pre-treatment values, the following results were observed. Serum T4 concentration decreased in the three treatment groups and the decrease was similar in the MMI and MMI + SSKI groups but significantly lower than in the MMI + Na ipodate group. The serum T3 concentration decreased to the normal range in all seven MMI+Na Ipodate treated patients by the fourth day of treatment and the per cent decrease in serum T3 from pre-treatment values was significantly greater than in the MMI and MMI + SSKI treated patients. The decrease in serum T3 was similar in the latter two groups. Heart rate decreased in all three groups, but the decrease was significantly more in the MMI+Na Ipodate-treated patients. The present findings suggest that the rapid control of hyperthyroid Graves’ disease is similar in patients treated with MMI and MMI+SSKI and that the combination of MMI+Na Ipodate is more efficacious since the decrease in serum T3 concentrations and heart rate was significantly greater in the MMI + Na ipodate-treated patients. Stable iodine in combination with anti-thyroid drugs is generally recommended when a rapid return to normal of serum thyroid hormone concentrations is required, such as in the treatment of patients with thyroid storm and in those undergoing urgent thyroidec- Correspondence: Dr L. Braverman, Division of Endocrinology and Metabolism, University of Massachu- setts Medical School, Worcester, MA 01605, USA. 305