Methadone, QTc interval prolongation, and torsade de pointes

Abstract: We reviewed the literature and found 31 adult cases and 1 newborn case of methadone-associated QTc interval prolongation and/or torsade de pointes (TdP).

Parametric statistics may not be useful in studying this issue because methadone-associated TdP is a very rare event and, hence, “an extreme outlier” consistent with scalable randomness. We may have to rely upon narrative medicine in the form of case reports with all its limitations and hazards to provide our best understanding.

We report risk factors for methadone-associated QTc interval prolongation and TdP based on review of published case reports.

We believe both drug manufacturers and the FDA would better serve our patients and inform clinicians if they more readily reported drug-induced outliers such as methadone-associated TdP using a case report format.

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  • Forfattere: W. Victor R. Vieweg, Mehrul Hasnain, Robert H. Howland, Thomas Clausen, Jayanthi N. Koneru, Christopher Kogut, Ericka L. Breden Crouse, Jules C. Hancox, Antony Fernandez, Ananda K. Pandurangi
  • Publisert: Therapeutic Advances in Psychopharmacology January 21, 2013 2045125312469982

 

Publisert 15. mars 2013 11:37 - Sist endret 15. mars 2013 11:37