Methadone, QTc interval prolongation and torsade de pointes: Case reports offer the best understanding of this problem

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

Research output: Contribution to journalArticle (Academic Journal)peer-review

19 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)219-32
Number of pages14
JournalTherapeutic Advances in Psychopharmacology
Volume3
Issue number4
DOIs
Publication statusPublished - Aug 2013

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