Torsade de Pointes Due to Methadone
Authors: Montserrat Sala, Ignasi Anguera, Manuel Cervantes
Journal: Annals of Internal Medicine (2003)

Letters19 August 2003Torsade de Pointes Due to MethadoneMontserrat Sala, MD, Ignasi Anguera, MD, and Manuel Cervantes, MDMontserrat Sala, MDInstitut Universitari Parc Taul, Hospital de Sabadell; 08208 Sabadell, Barcelona, Spain (Sala, Anguera, Cervantes)Search for more papers by this author, Ignasi Anguera, MDInstitut Universitari Parc Taul, Hospital de Sabadell; 08208 Sabadell, Barcelona, Spain (Sala, Anguera, Cervantes)Search for more papers by this author, and Manuel Cervantes, MDInstitut Universitari Parc Taul, Hospital de Sabadell; 08208 Sabadell, Barcelona, Spain (Sala, Anguera, Cervantes)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-4-200308190-00021-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read the paper by Krantz and colleagues (1) about torsades de pointes in patients treated with methadone. In our hospital, four HIV-infected patients receiving methadone therapy presented with episodes of syncope. All of them had a prolongation of the corrected QT interval (QTc) (<0.45 seconds) and several episodes of torsades de pointes. All of the patients were men, and the mean age was 35 years. When the syncope occurred, two patients had AIDS and three were taking antiretroviral therapy with reverse transcriptase inhibitors. The mean daily methadone dose was 365 mg (range, 275 to 500 mg), ...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. Kocheril AG, Bokhari SA, Batsford WP, Sinusas AJ. Long QTc and torsades de pointes in human immunodeficiency virus disease. Pacing Clin Electrophysiol. 1997;20:2810-6. [PMID: 9392812] CrossrefMedlineGoogle Scholar3. Villa A, Foresti V, Confalonieri F. Autonomic neuropathy and prolongation of QT interval in human immunodeficiency virus infection. Clin Auton Res. 1995;5:48-52. [PMID: 7780290] CrossrefMedlineGoogle Scholar4. Mantelli L, Corti V, Bini R, Cerbai E, Ledda F. Effects of dl-methadone on the response to physiological transmitters and on several functional parameters of the isolated guinea-pig heart. Arch Int Pharmacodyn Ther. 1986;282:298-313. [PMID: 2876691] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Institut Universitari Parc Taul, Hospital de Sabadell; 08208 Sabadell, Barcelona, Spain (Sala, Anguera, Cervantes) 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 Torsade de Pointes Due to Methadone Evan O. Mokwe and Opara Ositadinma Metrics Cited byArrhythmogenesis and Prolonged Repolarization From Synthetic Opioids: Finally Sorted?Magnetocardiographic identification of prolonged fetal corrected QT interval in women receiving treatment for opioid use disorderIncreased incidence of QT interval prolongation in a population receiving lower doses of methadone maintenance therapyRevue des cas d’allongements du QTC et de torsades de pointe chez des patients traités par méthadoneMonitoring electrocardiograms of service users on high-dose methadone substitution therapy: an auditCardiotoxicity 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-associated long QT syndrome: improving pharmacotherapy for dependence on illegal opioids and lessons learned for pharmacologyMethadone Death, Dosage and Torsade de Pointes: Risk-Benefit Policy ImplicationsSubstance misuse 19 August 2003Volume 139, Issue 4Page: W-64KeywordsAntiretroviral therapyDrug interactionsDrug therapyDrugsGeneticsHeart rateNeuropathyPotassiumReverse transcriptase inhibitorsSyncope ePublished: 19 August 2003 Issue Published: 19 August 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...