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Ehret et al¹ pointed out the high frequency of methadone-induced long QT syndrome (LQTS) among hospitalized drug users and its risk factors. Interestingly, in their study only 4 of 50 patients with LQTS induced by methadone hydrochloride also had torsades de pointes (TdP).¹ Moreover, although methadone use might have been associated with LQTS in outpatients as well as in inpatients,^1-2 and although millions of patients have been using methadone since the 1960s, only 43 patients with methadone-induced TdP were reported to the US Food and Drug Administration up to October 2002.³ Therefore, it is possible that methadone, just like amiodarone,⁴ might be normally associated with LQTS and rarely with TdP. If this is the case, preventing methadone-induced LQTS and preventing methadone-induced TdP is not the same. In fact, in the study by Ehret et al,¹ 2 patients had TdP, although their corrected QT (QTc) intervals were within normal range.¹

Possibly, . . . [Full Text of this Article]

AUTHOR INFORMATION
Dan Justo, MD

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RELATED LETTER

Drug-Induced Long QT Syndrome in Injection Drug Users Receiving Methadone: High Frequency in Hospitalized Patients and Risk Factors
Georg B. Ehret, Cathy Voide, Marianne Gex-Fabry, Jocelyne Chabert, Dipen Shah, Barbara Broers, Valérie Piguet, Thierry Musset, Jean-Michel Gaspoz, Arnaud Perrier, Pierre Dayer, and Jules A. Desmeules
Arch Intern Med. 2006;166(12):1280-1287.
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