Galantamine hydrobromide, an FDA-approved drug for Alzheimer’s, has recently revealed anti-inflammatory, antioxidant and antiapoptotic effects that can be subjected for further indications other that neurodegenerative diseases. Despite of lithium carbonate’s effectiveness in psychiatry, it has multiple organ toxic effects and thyroid dysfunction is one of the most prevalent adverse effects of lithium therapy, however, the precise etiology is still ambiguous. The purpose of this study was to evaluate the possible prophylactic antioxidant, anti-inflammatory and antiapoptotic effects of galantamine hydrobromide, alone or in combination with vitamin E against lithium induced thyroid dysfunction in rats. This experiment was performed on 40 male Wistar albino rats divided randomly into 5 groups. Group 1 was control group. Group 2 received lithium alone. Group 3 received lithium and galantamine hydrobromide. Group 4 received lithium and vitamin E. Group 5 received lithium, galantamine hydrobromide and vitamin E. Blood was collected to evaluate thyroid function (triiodothyronine T3, thyroxin T4, thyroid stimulating hormones (TSH levels), and assess levels of total antioxidant capacity (TAC), Malondialdehyde (MDA), and tumor necrosis factor alpha (TNFα). Then, both lobes of thyroid glands were dissected and processed for histopathological changes and immunohistochemical expression of (Caspase-3). The results of the study showed that combined treatment of galantamine hydrobromide and vitamin E provide marked prophylactic anti-inflammatory, antioxidant and anti-apoptotic effects against lithium induced thyroid toxicity. However, galantamine alone was more effective than vitamin E.