Torsades de Pointes Due to Methadone
Authors: David De Bels, Michel Staroukine, Jacques Devriendt
Journal: Annals of Internal Medicine (2003)

Letters15 July 2003Torsades de Pointes Due to MethadoneDavid De Bels, MD, Michel Staroukine, MD, and Jacques Devriendt, MDDavid De Bels, MDBrugmann University Hospital; 1020 Brussels, Belgium (De Bels, Staroukine, Devriendt), Michel Staroukine, MDBrugmann University Hospital; 1020 Brussels, Belgium (De Bels, Staroukine, Devriendt), and Jacques Devriendt, MDBrugmann University Hospital; 1020 Brussels, Belgium (De Bels, Staroukine, Devriendt)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-2-200307150-00021-w2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with much interest the article by Krantz and colleagues on torsades de pointes associated with long-term, very high doses of methadone (1). We observed two cases of acute methadone intoxication associated with a lengthening of the QT interval and torsades de pointes.The first patient was found unconscious. Toxicology showed therapeutic concentrations of diazepam, nordiazepam, propoxyphene, and norpropoxyphene. Plasma concentrations of bromazepam and methadone were 277 g/L (toxic level, >250 g/L) and 3500 g/L (toxic level, >1000 g/L), respectively. Traces of cocaine were in the urine. There were no ionic abnormalities. Electrocardiography showed a sinus ...References1. Krantz MJ, Lewkowiez L, Hays H, Woodroffe MA, Robertson AD, Mehler PS. Torsade de pointes associated with very-high-dose methadone. Ann Intern Med. 2002;137:501-4. [PMID: 12230351] LinkGoogle Scholar2. Bazett HC. An analysis of the time-relations of electrocardiograms. Heart. 1920;7:353-70. Google Scholar Author, Article, and Disclosure InformationAffiliations: Brugmann University Hospital; 1020 Brussels, Belgium (De Bels, Staroukine, Devriendt) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTorsade de Pointes Associated with Very-High-Dose Methadone Mori J. Krantz , Laurent Lewkowiez , Helen Hays , Mary Ann Woodroffe , Alastair D. Robertson , and Philip S. Mehler The Impact of Methadone Induction on Cardiac Conduction in Opiate Users Bridget A. Martell , Julia H. Arnsten , Beevash Ray , and Marc N. Gourevitch Metrics Cited byUtilizing postmortem drug concentrations in mechanistic modeling and simulation of cardiac effects: a proof of concept study with methadoneA possible biomarker for methadone related deathsOpioid Pharmacology and PharmacokineticsKCNH2 polymorphism and methadone dosage interact to enhance QT durationPharmacogenetics of opiates in clinical practice: the visible tip of the icebergRevue des cas d'allongements du QTC et de torsades de pointe chez des patients traités par méthadoneQT Interval Screening in Methadone Maintenance Treatment: Report of a SAMHSA Expert PanelMonitoring electrocardiograms of service users on high-dose methadone substitution therapy: an auditRetrospective analysis of low-dose methadone and QTc prolongation in chronic pain patientsQTc Interval Screening in Methadone TreatmentMori J. Krantz, MD, Judith Martin, MD, Barry Stimmel, MD, Davendra Mehta, MD, and Mark C.P. Haigney, MDDRUGS OF ABUSEADVERSE CARDIOVASCULAR EFFECTS OF NON-CARDIOVASCULAR DRUGSCardiotoxicity of Oral Methadone as an Analgesic–-Recommendations for Safe UseA Community-Based Evaluation of Sudden Death Associated with Therapeutic Levels of MethadoneStereoselective Block of hERG Channel by (S)-Methadone and QT Interval Prolongation in CYP2B6 Slow MetabolizersMethadone Death, Dosage and Torsade de Pointes: Risk-Benefit Policy ImplicationsMethadone-associated Torsades de Pointes (polymorphic ventricular tachycardia) in opioid-dependent patientsSubstance misuseMethadone-relatedtorsades de pointes in a sickle cell patient treated for chronic painCocaine-Related Torsade de Pointes in a Methadone Maintenance PatientDrugs of abuse 15 July 2003Volume 139, Issue 2Page: W-58KeywordsAttentionBlood plasmaCocaineElectrocardiographyIntoxicationLoss of consciousnessMagnesiumPotassiumShockUrine ePublished: 15 July 2003 Issue Published: 15 July 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...