A prospective study on the effects of Different methadone dosages on qtc Interval in opiate dependent individuals Receiving methadone maintenance therapy (mmt)
A PROSPECTIVE STUDY ON THE EFFECTS OF DIFFERENT METHADONE DOSAGES ON QTc INTERVAL AMONG OPIATE DEPENDENT INDIVIDUALS RECEIVING METHADONE MAINTENANCE THERAPY (MMT). Methadone is an effective treatment for opioid dependence and chronic pain. However, recent evidence suggests it also prolongs the Q...
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| Format: | Thesis |
| Language: | English |
| Published: |
2012
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| Online Access: | http://eprints.usm.my/60969/ http://eprints.usm.my/60969/1/DR%20AZLIE%20BIN%20HASSAN%20-%20e.pdf |
| _version_ | 1848884584152825856 |
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| author | Hassan, Azlie |
| author_facet | Hassan, Azlie |
| author_sort | Hassan, Azlie |
| building | USM Institutional Repository |
| collection | Online Access |
| description | A PROSPECTIVE STUDY ON THE EFFECTS OF DIFFERENT METHADONE
DOSAGES ON QTc INTERVAL AMONG OPIATE DEPENDENT
INDIVIDUALS RECEIVING METHADONE MAINTENANCE THERAPY
(MMT). Methadone is an effective treatment for opioid dependence and chronic pain.
However, recent evidence suggests it also prolongs the QTc interval, resulting in
torsade de pointes (TdP), a prerequisite to fatal cardiac arrhythmia, ventricular
fibrillation (VF). Although higher doses of methadone are clearly more efficacious in
reducing illicit opioid abuse, arrhythmia risk appears to increase in parallel creating an
efficacy-safety paradox. This study investigates the effects of different methadone
dosages on the QTc interval in opioid dependent individuals undergoing MMT over an
eight week period. To compare the QTc interval duration between low and high dose
methadone groups. To determine the correlation between QTc interval and different methadone
doses. To determine the proportion of prolonged QTc interval amongst methadone
treated patients at different methadone dosages. To determine the association of prolonged QTc interval between low and
high dose methadone groups. A prospective cohort study for a six months duration was done from June until
December 2010 on eligible subjects undergoing Methadone Maintenance Therapy (MMT) in HUSM. The QTc intervals were measured at the beginning of the study (week 0) and measured again during follow up at week 4 and week 8 of study period.
Serum potassium, calcium and magnesium along with serum methadone levels were
also measured at each visit. The association between prolonged QTc interval and different methadone dose groups as well as other parameters was analyzed using SPSS
version 18.0. There were 46 patients enrolled into the study during the study period. No
patient had a QTc interval of more than 500 ms during the study period. There were no
statistically significant correlation between QTc interval and both clinical dose and
plasma methadone level (r = 0.22,/? = 0.148 and r = 0.08,/? = 0.617 respectively). There was a marginally significant association between prolonged QTc interval and methadone dose group at week 0 [p = 0.044, OR 4.29 (0.98,18.72. In week 4, there was a significant association between prolonged QTc interval and methadone dose [p - 0.013, OR 5.18 (1.34,20.06)]. However, the QTc interval prolongation was not
associated with different methadone dose in week 8 [p = 0.139, OR 2.44 (0.74,8.01)].
Further analysis with RM ANOVA revealed a significant increase of QTc interval over
time (p = 0.005). We concluded that opiate dependent individuals who received MMT showed a
progressive QTc interval prolongation over the course of methadone treatment. Subjects
who were receiving methadone dose of greater than 80 mg per day are more likely to
develop prolonged QTc interval compared to subjects receiving less than 80 mg of
methadone daily. However, the effects of the different methadone dosages on QTc
interval were not consistent throughout the study period, suggesting the complex and
fluctuating nature of methadone induced QTc interval prolongation even when the dose
remained constant. |
| first_indexed | 2025-11-15T19:09:01Z |
| format | Thesis |
| id | usm-60969 |
| institution | Universiti Sains Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T19:09:01Z |
| publishDate | 2012 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | usm-609692024-08-19T08:30:13Z http://eprints.usm.my/60969/ A prospective study on the effects of Different methadone dosages on qtc Interval in opiate dependent individuals Receiving methadone maintenance therapy (mmt) Hassan, Azlie R Medicine (General) RA440-440.87 Study and teaching. Research A PROSPECTIVE STUDY ON THE EFFECTS OF DIFFERENT METHADONE DOSAGES ON QTc INTERVAL AMONG OPIATE DEPENDENT INDIVIDUALS RECEIVING METHADONE MAINTENANCE THERAPY (MMT). Methadone is an effective treatment for opioid dependence and chronic pain. However, recent evidence suggests it also prolongs the QTc interval, resulting in torsade de pointes (TdP), a prerequisite to fatal cardiac arrhythmia, ventricular fibrillation (VF). Although higher doses of methadone are clearly more efficacious in reducing illicit opioid abuse, arrhythmia risk appears to increase in parallel creating an efficacy-safety paradox. This study investigates the effects of different methadone dosages on the QTc interval in opioid dependent individuals undergoing MMT over an eight week period. To compare the QTc interval duration between low and high dose methadone groups. To determine the correlation between QTc interval and different methadone doses. To determine the proportion of prolonged QTc interval amongst methadone treated patients at different methadone dosages. To determine the association of prolonged QTc interval between low and high dose methadone groups. A prospective cohort study for a six months duration was done from June until December 2010 on eligible subjects undergoing Methadone Maintenance Therapy (MMT) in HUSM. The QTc intervals were measured at the beginning of the study (week 0) and measured again during follow up at week 4 and week 8 of study period. Serum potassium, calcium and magnesium along with serum methadone levels were also measured at each visit. The association between prolonged QTc interval and different methadone dose groups as well as other parameters was analyzed using SPSS version 18.0. There were 46 patients enrolled into the study during the study period. No patient had a QTc interval of more than 500 ms during the study period. There were no statistically significant correlation between QTc interval and both clinical dose and plasma methadone level (r = 0.22,/? = 0.148 and r = 0.08,/? = 0.617 respectively). There was a marginally significant association between prolonged QTc interval and methadone dose group at week 0 [p = 0.044, OR 4.29 (0.98,18.72. In week 4, there was a significant association between prolonged QTc interval and methadone dose [p - 0.013, OR 5.18 (1.34,20.06)]. However, the QTc interval prolongation was not associated with different methadone dose in week 8 [p = 0.139, OR 2.44 (0.74,8.01)]. Further analysis with RM ANOVA revealed a significant increase of QTc interval over time (p = 0.005). We concluded that opiate dependent individuals who received MMT showed a progressive QTc interval prolongation over the course of methadone treatment. Subjects who were receiving methadone dose of greater than 80 mg per day are more likely to develop prolonged QTc interval compared to subjects receiving less than 80 mg of methadone daily. However, the effects of the different methadone dosages on QTc interval were not consistent throughout the study period, suggesting the complex and fluctuating nature of methadone induced QTc interval prolongation even when the dose remained constant. 2012-05 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/60969/1/DR%20AZLIE%20BIN%20HASSAN%20-%20e.pdf Hassan, Azlie (2012) A prospective study on the effects of Different methadone dosages on qtc Interval in opiate dependent individuals Receiving methadone maintenance therapy (mmt). Masters thesis, Universiti Sains Malaysia. |
| spellingShingle | R Medicine (General) RA440-440.87 Study and teaching. Research Hassan, Azlie A prospective study on the effects of Different methadone dosages on qtc Interval in opiate dependent individuals Receiving methadone maintenance therapy (mmt) |
| title | A prospective study on the effects of
Different methadone dosages on qtc
Interval in opiate dependent individuals
Receiving methadone maintenance therapy
(mmt) |
| title_full | A prospective study on the effects of
Different methadone dosages on qtc
Interval in opiate dependent individuals
Receiving methadone maintenance therapy
(mmt) |
| title_fullStr | A prospective study on the effects of
Different methadone dosages on qtc
Interval in opiate dependent individuals
Receiving methadone maintenance therapy
(mmt) |
| title_full_unstemmed | A prospective study on the effects of
Different methadone dosages on qtc
Interval in opiate dependent individuals
Receiving methadone maintenance therapy
(mmt) |
| title_short | A prospective study on the effects of
Different methadone dosages on qtc
Interval in opiate dependent individuals
Receiving methadone maintenance therapy
(mmt) |
| title_sort | prospective study on the effects of
different methadone dosages on qtc
interval in opiate dependent individuals
receiving methadone maintenance therapy
(mmt) |
| topic | R Medicine (General) RA440-440.87 Study and teaching. Research |
| url | http://eprints.usm.my/60969/ http://eprints.usm.my/60969/1/DR%20AZLIE%20BIN%20HASSAN%20-%20e.pdf |