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December 1, 1945

USE OF THIOBARBITAL IN THE TREATMENT OF HYPERTHYROIDISM

JAMA. 1945;129(14):932-935. doi:10.1001/jama.1945.02860480012003
Abstract

Astwood1 has reported that diethyl thiobarbituric acid (thiobarbital) has antithyroid activity similar to that of thiouracil. Experiments on rats showed that thiobarbital in small doses was somewhat more effective in inhibiting thyroid function and perhaps less toxic than thiouracil. In larger doses, however, animals receiving thiobarbital were noted to have fatty infiltration of the liver. Astwood has been using thiobarbitol in clinical hyperthyroidism since February 1944 and has made a report on his results.1a

The opportune moment for our initial trial use of thiobarbital came in October 1944 when a patient receiving thiouracil developed a fever reaction necessitating discontinuance of treatment and in whom further antithyroid therapy was thought essential before thyroidectomy. This first patient to receive thiobarbital (chart 1) was an extremely fragile woman aged 75 with severe hyperthyroidism of five years' duration due to an adenomatous goiter. She weighed 83 pounds (37.6 Kg.) and had a

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