Methadone overdose and cardiac arrhythmia potential: findings from a review of the evidence for an American Pain Society and College on Problems of Drug Dependence clinical practice guideline.

摘要: Abstract The number of deaths associated with methadone use increased dramatically in parallel marked increases its use, particularly for treatment chronic pain. To develop a clinical guideline on prescribing to reduce potential harms, the American Pain Society commissioned review various aspects related safety. This article summarizes evidence unintentional overdose due and harms cardiac arrhythmia potential. We searched Ovid MEDLINE, Cochrane Library, PsycINFO databases through January 2014 studies assessing use; we judged 70 be relevant meet inclusion criteria. majority risk are observational provide weak which base guidelines. In patients prescribed opioid dependence, data suggest that mortality benefits reduction illicit drug outweigh harms. Despite epidemiologic showing numbers methadone-related have been primarily attributed pain, this population has somewhat contradictory. There is some recent initiation methadone, psychiatric admissions, concomitant benzodiazepines higher overdose. Evidence risks limited case reports torsades de pointes, high doses an association between prolongation QTc intervals. Research needed understand effectiveness dosing methods, electrocardiogram monitoring, other mitigation strategies methadone. Perspective systematic synthesizes arrhythmia. Findings regarding interval factors methadone-associated targets strategies, though research determine such at reducing adverse outcomes.