Methadone and torsade de pointes: case report and review of the literature.
Methadone, a synthetic opioid, has been used for more than 35 years to treat heroin addiction. It is also an effective therapy for chronic pain. An increase in the mean dose used nationally to treat these patients has been reported. There is an ongoing debate over whether it is necessary to screen patients with an ECG before and during therapy with methadone. We present a patient who developed QT prolongation and sustained ventricular arrhythmias after her methadone dose was increased. Previous literature, as well as the mechanism and risk factors, will be reviewed in this article. Recommendations will be given as to when an ECG is preferably to be performed.
Iskandar
Said B
SB
Division of Cardiology, East Tennessee State University, Johnson City, USA. drsiskandar@hotmail.com
Abi-Saleh
Bernard S
BS
Mechleb
Bassam K
BK
Fahrig
Stephen A
SA
D000328:Adult; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008691:Methadone / Q000009:adverse effects* / Q000627:therapeutic use; D009294:Narcotics / Q000009:adverse effects* / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
D009294:Narcotics; D008691:Methadone