Wilson’s disease

Appropriate anticopper therapy for Wilson’s disease is the critical element in halting progression of the disease and allowing patient recovery. Selection of the drug or drugs to use for a particular patient depends on the stage of the disease (ie, initial acutely ill patient versus chronic maintenance patient) and the type of presentation (ie, neurologic/psychiatric versus hepatic). I treat patients initially presenting with hepatic disease with a combination of zinc and trientine, those presenting with neurologic/psychiatric disease with tetrathiomolybdate, and those in the maintenance phase with zinc.