Reserpine in propranolol-resistant thyroid storm.

beta-Adrenergic blockers are considered the drugs of choice in the management of the hyperadrenergic state in hyperthyroidism. However, we observed a patient in thyroid storm and coma who failed to respond to large doses of oral and intravenous propranolol hydrochloride but who responded promptly to intramuscular reserpine. Reserpine may have been lifesaving and should be considered in propranolol-resistant hyperthyroidism and in hyperthyroid patients in whom propranolol is contraindicated.