QTc and Perceived Sleep Follow up Among Chronic Pain Patients With Opiate Medication
Unknown status
Tel-Aviv Sourasky Medical Center
N/A
2010-01-01
QTc:
Since the reports of three deaths attributed to Torsade de Point (TdP) related to treatment
with the long-acting methadone derivative levomethadyl acetate HCl (LAAM), methadone has been
scrutinized for any possible association with TdP. Since then, several studies among
Methadone Maintenance Treatment (MMT) patients and chronic pain patients were done, reporting
diverse results about possible association between methadone dose and QTc prolongation. Most
studies however were cross-sectional and generally found insignificant clinical prolongation
of QTc. A follow up studies are of importance, and although few studies have started
evaluating QTc among MMT patients, none was done among chronic pain patients with no history
of drug usage. One study of 8 chronic pain patients experiencing insufficient pain control or
intolerable side effects during treatment with oral morphine switched to oral methadone
showed insignificant modest increase QTc following 9 month.
Perceived Sleep:
Chronic pain patients as well as drug addicts are known to suffer from poor sleep. Some
studies found possible relation to methadone dose, however, no causal association was found
and importantly some also found association with duration of opiate usage before starting
methadone when entry to MMT clinic. Thus, patients with no history of opiate addiction are an
important interesting group that may help understand relation between methadone usage and
sleep quality. However, sleep must be evaluate before opiate administration and a follow up
study is needed
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