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Heroin Addiction and Related Clinical Problems: 2006, 08, 4 (pages: 42 - 52)

QTc Prolongation in Methadone Maintenance: Fact and Fiction

Schmittner J., Krantz M. J.

Summary: Methadone is an effective treatment for opioid dependence- and, until recently, was viewed as a medication without cardiac properties. High-dose therapy has been linked to prolongation of the rate-corrected QT interval (QTc) and torsade de pointes (TdP), a form of ventricular tachycardia requiring QTc prolongation. To date, only one prospective study has demonstrated a modest increase in QTc with methadone. Arrhythmia risk is related to the magnitude of the QTc change from baseline. Clinicians should be aware of methadone's potential cardiovascular effects and weigh the benefit-to-risk ratio for each patient, based upon individual risk for arrhythmia.