Objective: Lithium carbonate is primarily used for the treatment of patients with bipolar affective disorders. Initial treatment of Graves' hyperthyroidism (GHT) with antithyroid drugs (ATD) has limitations at over 50% of treated patients because of significant side effects and relatively high relapses of the disease after drugs withdrawal. Till now, the influence of LiCO₃on RIT outcome was mainly studied in patients with recent onset of GHT, and results were contradicted. Meta-analysis of case-control studies showed higher rated hypothyroidism in patients with mood disorders treated with LiCO₃(121/869) than in controls (10/578). Although in a small number of patients (n=28) with long-lasting GHT, preliminary results of ours showed that ¹³¹I treatment with LiCO₃for 7 days significantly improved the efficacy of RIT versus the non-LiCO₃treated patients (P<0.001). Lithium treated patients were cured faster (12 of 13 patients were cured after one month) than those treated only with ¹³¹I (8 patients were cured after one and 11/15 patients after 12 months). Fewer patients treated with ¹³¹I and LiCO₃had persistent hyperthyroidism than those treated with ¹³¹I alone. There were no toxic effects of LiCO₃during 7 days treatment.
Conclusion: These observations indicate of that short-term treatment with LiCO₃in GHT patients as adjunct to ¹³¹I-NaI improves the efficacy of RIT, prevents transient exacerbation of hyperthyroidism, early induction of hypothyroidism and does not worsen ophthalmopathy.