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Volume 11
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10.3390/biomedicines11082109
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Article

Methadone Maintenance and QT-Interval: Prevalence and Risk Factors—Is It Effective to Switch Therapy to Levomethadone?

by
Laura Santin
1,
Giuseppe Verlato
2,
Ahmad Tfaily
2,
Roberto Manera
3,
Giuseppe Zinfollino
3,
Francesca Fusina
4 and
Fabio Lugoboni
1,*
1
Addiction Unit, Department of Medicine, Verona University Hospital, 37134 Verona, Italy
2
Section of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
3
Addiction Department, ULSS 2, 31100 Treviso, Italy
4
Padova Neuroscience Center, University of Padua, 35122 Padua, Italy
*
Author to whom correspondence should be addressed.
Biomedicines 2023, 11(8), 2109; https://doi.org/10.3390/biomedicines11082109
Submission received: 28 May 2023 / Revised: 20 July 2023 / Accepted: 24 July 2023 / Published: 26 July 2023
(This article belongs to the Special Issue Advances in Treatment of Drug Addiction)
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Abstract

Methadone is a chiral synthetic opioid primarily used to treat heroin and prescription-opioid addiction: the (R)-enantiomer (Levomethadone) activates the µ-opioid receptor more potently than the (S)-enantiomer, which is a more potent blocker of the hERG potassium channels, resulting in QTc prolongation. The purpose of this retrospective study was to assess the effect of methadone on the QTc interval and to investigate the benefits of Levomethadone. The electrocardiograms of 165 patients taking methadone at various dosages and for different periods of time were examined: the QTc value was manually measured and then adjusted using Bazett’s formula. Data analysis revealed a linear association between the dosage of methadone and QTc length; no correlation was found between the QTc value and gender, age, or duration of therapy. In total, 14% of the sample (23 patients) showed a prolongation of the QTc interval (>470 ms in males and >480 ms in females); 10 of the 23 patients with QTc elongation underwent a change of therapy from Methadone to Levomethadone—in 90% of these patients, a normalization in the QTc length was established. This study confirmed the role of methadone, specifically its dosage, in QTc prolongation and the efficiency of Levomethadone as an adequate therapeutic substitute in these circumstances. This study validates the importance of careful electrocardiographic monitoring in methadone-treated patients.
Keywords: methadone; levomethadone; QTc; prolongation; treatment; heroin; therapy-switch methadone; levomethadone; QTc; prolongation; treatment; heroin; therapy-switch

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MDPI and ACS Style

Santin, L.; Verlato, G.; Tfaily, A.; Manera, R.; Zinfollino, G.; Fusina, F.; Lugoboni, F. Methadone Maintenance and QT-Interval: Prevalence and Risk Factors—Is It Effective to Switch Therapy to Levomethadone? Biomedicines 2023, 11, 2109. https://doi.org/10.3390/biomedicines11082109

AMA Style

Santin L, Verlato G, Tfaily A, Manera R, Zinfollino G, Fusina F, Lugoboni F. Methadone Maintenance and QT-Interval: Prevalence and Risk Factors—Is It Effective to Switch Therapy to Levomethadone? Biomedicines. 2023; 11(8):2109. https://doi.org/10.3390/biomedicines11082109

Chicago/Turabian Style

Santin, Laura, Giuseppe Verlato, Ahmad Tfaily, Roberto Manera, Giuseppe Zinfollino, Francesca Fusina, and Fabio Lugoboni. 2023. "Methadone Maintenance and QT-Interval: Prevalence and Risk Factors—Is It Effective to Switch Therapy to Levomethadone?" Biomedicines 11, no. 8: 2109. https://doi.org/10.3390/biomedicines11082109

APA Style

Santin, L., Verlato, G., Tfaily, A., Manera, R., Zinfollino, G., Fusina, F., & Lugoboni, F. (2023). Methadone Maintenance and QT-Interval: Prevalence and Risk Factors—Is It Effective to Switch Therapy to Levomethadone? Biomedicines, 11(8), 2109. https://doi.org/10.3390/biomedicines11082109

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