Neurological Manifestations of Thyroid Disease Medication

  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Nicholas Lorenzo, MD   more...
 
Updated: Oct 17, 2011
 

Medication Summary

The goal is to establish a euthyroid state. In hypothyroidism, this involves thyroid replacement, which is attained readily. In hyperthyroidism, elevated thyroid hormone is treated with surgery, which causes hypothyroidism and requires thyroid replacement, or with drugs and radioactive iodine.

Symptoms that are associated with abnormal thyroid states are treatable.

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Thiourea derivatives

Class Summary

These medications are preferred for suppressing thyroid function.

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Propylthiouracil (PTU)

 

Derivative of thiourea that inhibits organification of iodine by thyroid gland. Also inhibits conversion of T4 to T3, which is advantage over other agents.

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Methimazole (Tapazole)

 

Suppresses thyroid function and has mechanism similar to that of PTU; does not inhibit peripheral conversion of T4 to T3.

Fifteen times as potent as PTU. PTU equivalent dosing can be used, divided tid.

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Beta-adrenergic blocking agents

Class Summary

These agents are used to treat symptomatic hyperthyroidism.

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Propranolol (Inderal)

 

This nonselective, beta-adrenergic blocking agent treats symptomatic tachycardia. Has membrane-stabilizing activity and decreases automaticity of contractions.

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Thyroid hormones

Class Summary

These agents are used in thyroid hormone replacement.

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Levothyroxine (Synthroid, Levoxyl)

 

Synthetic, but identical to natural T4; in its active form, influences growth and maturation of tissues; is involved in normal growth, metabolism, and development.

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Electrolytes

Class Summary

These agents replace depleted electrolytes.

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Potassium chloride (K-DUR)

 

Essential for transmission of nerve impulses, maintenance of intracellular tonicity, and maintenance of normal renal function. Also vital for skeletal and smooth muscles. Replaces potassium lost in thyrotoxic periodic paralysis.

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Corticosteroids

Class Summary

These agents provide immunosuppressive therapy for Graves ophthalmopathy, especially in cases of severe exophthalmos.

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Prednisone (Deltasone, Sterapred, Orasone)

 

Widely used glucocorticoid that suppresses inflammatory processes by reversing increased capillary permeability and suppressing PMN activity; used to treat allergic, inflammatory, and autoimmune disorders.

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Tricyclic antidepressants

Class Summary

These agents may help relieve painful polyneuropathy.

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Amitriptyline (Elavil)

 

By inhibiting reuptake of serotonin and/or norepinephrine by presynaptic neuronal membrane, may increase synaptic concentration of these neurotransmitters in CNS; useful as analgesic for certain chronic and neuropathic pain.

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Antiepileptic agents

Class Summary

These agents are useful in treating neuropathic pain.

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Gabapentin (Neurontin)

 

Exact mechanism unknown. Structurally related to GABA; useful in some pain syndromes.

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Contributor Information and Disclosures
Author

Gabriel Bucurescu, MD, MS  Staff Neurologist, Neurology Service, Philadelphia Veterans Affairs Medical Center

Gabriel Bucurescu, MD, MS is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, and American Epilepsy Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas A Kent, MD  Professor and Director of Stroke Research and Education, Department of Neurology, Baylor College of Medicine; Chief of Neurology, Michael E DeBakey Veterans Affairs Medical Center

Thomas A Kent, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences, Royal Society of Medicine, Sigma Xi, and Stroke Council of the American Heart Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Agapito S Lorenzo, MD  Laboratory Director, Associate Professor, Departments of Neurology, Creighton University and University of Nebraska Medical Center

Agapito S Lorenzo, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Chief Editor

Nicholas Lorenzo, MD  Consulting Staff, Neurology Specialists and Consultants

Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and American College of Physician Executives

Disclosure: Nothing to disclose.

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