title: Successful transition to buprenorphine in a patient with methadone-induced torsades de pointes.
abstract: A 56-year-old-man presented with syncope and torsades de pointes secondary to methadone-induced QT prolongation. After transition from methadone to buprenorphine, a partial mu-opiate-receptor agonist and a kappa-opiate-receptor antagonist, the QT normalized and ventricular arrhythmias resolved. Buprenorphine should be used for opiate dependence and chronic pain in patients with methadone-induced QT prolongation and as first line therapy in patients with risk factors for torsades de pointes.
authors.affiliation: Department of Cardiology, Beth Israel Medical Center, 1st Ave. at 16th Street, Baird Hall, 5th Floor, New York, NY, 10003, USA.
authors.forename: Jason Levi
authors.initials: JL
authors.lastname: Esses
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rosman
authors.forename: Lien Thanh
authors.initials: LT
authors.lastname: Do
authors.forename: Paul
authors.initials: P
authors.lastname: Schweitzer
authors.forename: Sam
authors.initials: S
authors.lastname: Hanon
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine; D008691:Methadone