Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 28 12 2025 12 01 Medical Treatment of Hyperthyroidism; Efficacy and Safety Considerations 703 709 10.34172/aim.33502 EN Fereidoun Azizi https://orcid.org/0000-0002-6470-2517 Hengameh Abdi https://orcid.org/0000-0002-6850-0090 Seyed Alireza Ebadi Ladan Mehran Atieh Amouzegar https://orcid.org/0000-0001-9433-9408 REVIEW 10.34172/aim.33502 2024 11 17 2025 11 04 Antithyroid drugs (ATDs) are often the first treatment option for hyperthyroidism due to their efficacy and safety profile. Long-term ATD treatment can effectively control hyperthyroidism and prevent relapse. In this review, we summarize the findings of clinical trials and clinical experiences on the use of ATD treatment for hyperthyroidism. We discuss the efficacy and safety of ATD treatment, as well as the optimal duration of treatment. The evidence suggests that ATD therapy is selected as initial therapy, treatment of relapse of hyperthyroidism and in patients with persistent elevation of TSH receptor antibodies after 18 months of ATD therapy. Long-term ATD treatment can be an effective and safe option for management of many patients with hyperthyroidism. However, additional studies are needed to establish the most efficacious treatment duration and to identify patients who are most likely to benefit from long-term ATD treatment.