Opioid Treatment and Long QT Syndrome (LQTS): a Critical Review of the Literature

The present review aims at perusing the available literature about QT-related cardiac safety during methadone treatment. On the whole, case reports, either single or multiple, do not seem a reasonable bases to draw conclusions about the weight of any putative risk factor for QT prolongation. On the other hand, systematic studies allow making some statements about the extension and weight of QT prolongation during methadone maintenance treatment for heroin addiction. No major concern about cardiac safety of methadone itself in the average addict seems to stand. Conditions at higher risk of multiple and polydrug treatments deserve some greater surveillance. No rationale for a dose-ceiling stands in a risk/benefit perspective.