Reserpine in Thyrotoxic Crisis

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Abstract
In view of the beneficial effects of reserpine and beta-adrenergic blocking agents in thyrotoxicosis, we evaluated reserpine alone in seven thyrotoxic patients with eight episodes of thyroid storm. All had hyperthermia, exaggerated thyrotoxic signs and symptoms. All survived. Initially, 1 to 5 mg of reserpine was given intramuscularly, and 0.07 to 0.3 mg per kilogram of body weight was administered in the first 24 hours. Hyperthermia, hyperhidrosis, tachycardia and psychologic aberrations improved within four to eight hours. More rapid responses were seen with higher initial doses. In two patients mild diarrhea occurred; in one of these a transient cutaneous blush and increased tremor was noted on the first day. Hypotension did not occur, and cardiac failure when present improved. Reserpine in large parenteral doses appears to provide effective therapy for thyrotoxic crisis. It may be used alone or in conjunction with the usual modes of treatment.