01.07.2009   Alter: 8 yrs
Kategorie: Substitutionsbehandlung, Methadon

Mandatory QTc Screening for Methadone Patients – OTPs Respond to Published Guidelines


Health professionals and government agencies have raised concerns about methadone’s potential to produce QT prolongation, with or without the arrhythmia known as torsade de pointes (TdP), in patients in Opioid Treatment Programs (OTPs) and patients prescribed methadone for pain.

This possible risk recently led five clinicians to publish guidelines in the online Annals of Internal Medicine, calling for mandatory QTc screening by electrocardiogram (ECG) for all OTP patients, before starting methadone maintenance treatment, and periodically thereafter. Revisions of the Annals article subsequently appeared—then disappeared. A final version and related editorial were published in the March 17 print edition.

Many OTP clinicians share the authors’ concerns, but advocate screening or referral for a careful workup by a specialist after evaluation and assessment of risk. OTPs maintain that the costs and logistics of mandatory ECGs will deter some patients from entering potentially life-saving methadone therapy.