Successful transition to buprenorphine in a patient with methadone-induced torsades de pointes
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- Esses, J.L., Rosman, J., Do, L.T. et al. J Interv Card Electrophysiol (2008) 23: 117. doi:10.1007/s10840-008-9280-8
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A 56-year-old-man presented with syncope and torsades de pointes secondary to methadone-induced QT prolongation. After transition from methadone to buprenorphine, a partial μ-opiate-receptor agonist and a κ-opiate-receptor antagonist, the QT normalized and ventricular arrhythmias resolved. Buprenorphine should be used for opiate dependence and chronic pain in patients with methadone-induced QT prolongation and as first line therapy in patients with risk factors for torsades de pointes.