TY - JOUR
T1 - Methadone, QTc interval prolongation and torsade de pointes
T2 - Case reports offer the best understanding of this problem
AU - Vieweg, W Victor R
AU - Hasnain, Mehrul
AU - Howland, Robert H
AU - Clausen, Thomas
AU - Koneru, Jayanthi N
AU - Kogut, Christopher
AU - Crouse, Ericka L Breden
AU - Hancox, Jules C
AU - Fernandez, Antony
AU - Pandurangi, Ananda K
PY - 2013/8
Y1 - 2013/8
N2 - 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.
AB - 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.
U2 - 10.1177/2045125312469982
DO - 10.1177/2045125312469982
M3 - Article (Academic Journal)
C2 - 24167694
VL - 3
SP - 219
EP - 232
JO - Therapeutic Advances in Psychopharmacology
JF - Therapeutic Advances in Psychopharmacology
SN - 2045-1253
IS - 4
ER -