Book contents
- Frontmatter
- Contents
- Contributors
- Progress in Neurotherapeutics and Neuropsychopharmacology 2008
- Triflusal versus Aspirin for the Prevention of Stroke
- The Argatroban and tPA Stroke Study
- Use of Selegiline as Monotherapy and in Combination with Levodopa in the Management of Parkinson's Disease: Perspectives from the MONOCOMB Study
- Ropinirole 24-h Prolonged Release in Advanced Parkinson Disease: Review of a Randomized, Double-Blind, Placebo-Controlled Study (EASE PD-Adjunct Study)
- Insulin Resistance Alzheimer's Disease: Pathophysiology and Treatment
- Targeting Amyloid with Tramiprosate in Patients with Mild-to-Moderate Alzheimer Disease
- Intranasal Zolmitriptan Is Effective and Well Tolerated in Acute Cluster Headache: A Randomized Placebo-Controlled Double-Blind Crossover Study
- Optimal Dosing of Immunomodulating Drugs: A Dose-Comparison Study of GA in RRMS
- Tetrathiomolybdate versus Trientine in the Initial Treatment of Neurologic Wilson's Disease
- Randomized Clinical Trials of Pregabalin for Neuropathic Pain: Methods, Results, and Implications
- Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial
- Improvement in Speeded Cognitive Processing After Anti-epileptic Drug Withdrawal–A Controlled Study in Mono-therapy Patients
- A Randomized-Controlled Trial of Bilateral rTMS for Treatment-Resistant Depression
- Serotonin Related Genes Affect Antidepressant Treatment in Obsessive–Compulsive Disorder
- Night Eating Syndrome and Results from the First Placebo-Controlled Trial of Treatment, with the SSRI Medication, Sertraline: Implications for Clinical Practice
- Modafinil: A Candidate for Pharmacotherapy of Negative Symptoms in Schizophrenia
- New Approaches to Treatment of Schizophrenia by Enhancing N-methyl-D-aspartate Neurotransmission
- Subject Index
- Author Index
Tetrathiomolybdate versus Trientine in the Initial Treatment of Neurologic Wilson's Disease
Published online by Cambridge University Press: 13 May 2010
- Frontmatter
- Contents
- Contributors
- Progress in Neurotherapeutics and Neuropsychopharmacology 2008
- Triflusal versus Aspirin for the Prevention of Stroke
- The Argatroban and tPA Stroke Study
- Use of Selegiline as Monotherapy and in Combination with Levodopa in the Management of Parkinson's Disease: Perspectives from the MONOCOMB Study
- Ropinirole 24-h Prolonged Release in Advanced Parkinson Disease: Review of a Randomized, Double-Blind, Placebo-Controlled Study (EASE PD-Adjunct Study)
- Insulin Resistance Alzheimer's Disease: Pathophysiology and Treatment
- Targeting Amyloid with Tramiprosate in Patients with Mild-to-Moderate Alzheimer Disease
- Intranasal Zolmitriptan Is Effective and Well Tolerated in Acute Cluster Headache: A Randomized Placebo-Controlled Double-Blind Crossover Study
- Optimal Dosing of Immunomodulating Drugs: A Dose-Comparison Study of GA in RRMS
- Tetrathiomolybdate versus Trientine in the Initial Treatment of Neurologic Wilson's Disease
- Randomized Clinical Trials of Pregabalin for Neuropathic Pain: Methods, Results, and Implications
- Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial
- Improvement in Speeded Cognitive Processing After Anti-epileptic Drug Withdrawal–A Controlled Study in Mono-therapy Patients
- A Randomized-Controlled Trial of Bilateral rTMS for Treatment-Resistant Depression
- Serotonin Related Genes Affect Antidepressant Treatment in Obsessive–Compulsive Disorder
- Night Eating Syndrome and Results from the First Placebo-Controlled Trial of Treatment, with the SSRI Medication, Sertraline: Implications for Clinical Practice
- Modafinil: A Candidate for Pharmacotherapy of Negative Symptoms in Schizophrenia
- New Approaches to Treatment of Schizophrenia by Enhancing N-methyl-D-aspartate Neurotransmission
- Subject Index
- Author Index
Summary
ABSTRACT
Background: The initial treatment of the neurologic presentation of Wilson's disease is problematic. Penicillamine, used for years on most patients, causes neurologic worsening in up to half of such patients, and half of those who worsen never recover. Zinc, ideal for maintenance therapy, is too slow for these acutely ill patients. We have developed tetrathiomolybdate (TM) for this type of patient, and it has worked well in open label studies. Trientine, another anticopper drug on the market approved for penicillamine intolerant patients, had not been tried in this type of patient. Here, we report on a double blind trial of TM versus trientine in the neurologically presenting Wilson's disease patient. Design and Methods: The study was a double blind design in which patients received either TM plus zinc, or trientine plus zinc, for 8 weeks. Patients were accepted if they presented with neurologic symptoms from Wilson's disease, if they had not been treated longer than 4 weeks with penicillamine or trientine. Patients were followed in the hospital for the 8 weeks of treatment with weekly semiquantitative neurologic and speech examinations, to evaluate possible neurologic worsening. They also had blood and urine studies done weekly. At discharge from hospital they were continued on zinc maintenance therapy, and returned at yearly intervals for 3 years for further evaluation. Results: Twenty-three patients were entered into the trientine arm and 6 reached criteria for neurologic deterioration, while 25 patients were entered into the TM arm and only 1 deteriorated (p < 0.05).
- Type
- Chapter
- Information
- Progress in Neurotherapeutics and Neuropsychopharmacology , pp. 153 - 166Publisher: Cambridge University PressPrint publication year: 2008
- 3
- Cited by