Antithyroid Drugs

To the Editor: In his review of antithyroid drugs (March 3 issue), 1 Cooper does not mention the potential advantage of combined treatment with antithyroid drugs and thyroxine (referred to as the “block–replace regimen”). Even if such a regimen has not been demonstrated to be superior in terms of definitive cure, for many clinicians it is a simpler and faster way to achieve euthyroidism in most patients with Graves' disease than is treatment with methimazole alone. High doses of methimazole may be associated with more minor side effects, but in controlled studies the doses used ranged from 30 to 60 mg . . .