Prospective Study of QTc Changes Among Former Opiate Addicts Since Admission to Methadone Maintenance Treatment

被引:10
|
作者
Peles, Einat [1 ,2 ]
Linzy, Shirley [3 ,4 ]
Kreek, Mary Jeanne [5 ]
Adelson, Miriam [1 ,2 ,3 ,4 ,5 ]
机构
[1] Tel Aviv Sourasky Med Ctr, Dr Miriam Clin Drug Abuse Treatment & Res, IL-64239 Tel Aviv, Israel
[2] Tel Aviv Sourasky Med Ctr, Sheldon G Adelson Clin Drug Abuse Treatment & Res, IL-64239 Tel Aviv, Israel
[3] Dr Miriam Clin Drug Abuse Treatment & Res, Las Vegas, NV USA
[4] Sheldon G Adelson Clin Drug Abuse Treatment & Res, Las Vegas, NV USA
[5] Rockefeller Univ, Lab Biol Addict Dis, New York, NY 10021 USA
关键词
benzodiazepines; methadone maintenance treatment; prolonged QTc; prospective follow-up; TORSADE-DE-POINTES; INTERVAL PROLONGATION; PREVALENCE; RISK; LONG; BUPRENORPHINE; POPULATION; CONDUCTION; IMPACT; USERS;
D O I
10.1097/ADM.0b013e3182a8a4f2
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Objectives: To prospectively evaluate QTc changes among methadone maintenance treatment (MMT) patients. Methods: All 512 opiate addicts newly admitted to 2 MMT clinics had been prospectively studied for 4.5 years. Ninety-one patients were excluded because they were admitted from other MMTs, and 26 were excluded because their first electrocardiogram was performed following 28 days in MMT; therefore, 421 were studied. QTc values were again performed either after (A) a steady methadone dose for at least 3 months and negative urine tests for opiates, cocaine, amphetamines, cannabis, benzodiazepine; or after (B) same as for (A) but with positive urine tests for cannabis and/or benzodiazepine. Results: Mean QTc intervals were not related to benzodiazepine or cocaine use on admission. QTc interval was significantly prolonged from the baseline to steady methadone dose (424.5 +/- 23.2 ms and 438.6 +/- 26.6 ms, respectively) but not affected by methadone dose (<100 or >= 100 mg/d) or by the time to achieve a steady methadone dose (between 3 months and >2 years). QTc prolongation was greater among patients whose urine tested positive for benzodiazepine on a steady dose (P = 0.003). No additional prolongation was observed in 49 patients who achieved a steady methadone dose less than 1 year in MMT and had additional follow-up. Two patients who were benzodiazepine abusers died for undefined reasons. Conclusions: There is significant QTc prolongation during early MMT with no apparent clinical significance. A combination of benzodiazepine and methadone should be monitored.
引用
收藏
页码:428 / 434
页数:7
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