source: Graves’ Disease & Thyroid Foundation (GDATF)

year: 2021

Antithyroid medications (ATDs) have been prescribed for decades as a treatment option for hyperthyroidism in Graves’ disease patients. The U.S. Food and Drug Administration approved propylthiouracil in 1947 and methimazole (brand name Tapazole) in 1950.

In the past, endocrinologists typically prescribed ATDs for a limited period of time. Some doctors used 12-18 months as a benchmark, while others would keep patients on the medication for up to two years. Once the clock ran out, doctors stopped the medication and checked the patient’s thyroid function. If levels were in the normal range, the treatment was declared a success. If thyroid levels were still not well controlled (or if the patient became hyperthyroid again after stopping the medication) doctors would recommend radioactive iodine or surgery, which are definitive therapies that result in life-long hypothyroidism.

However, a paradigm shift in recent years – ushered in by new research as well as patient and physician preference – has brought changes to how these medications are used, with more patients remaining on antithyroid medications well past the two-year mark.

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