Since my last posting on the subject of higher dose methadone and cardiac arrythmias, there has been a growing volume of whispers on the subject. My sense of the present consensus is that on balance of risk, the benefits of effective methadone treatment far outweighs any theoretical (and very small) risk of methadone itself contributing to ventricular tacchyarrythmias. The advice remains (in the BNF) to exclude a prolonged QT interval by means of an ECG in those taking 100mg methadone daily or more, and if you see a prolonged QT interval, then seek a cardiologist's advice, don't stop the methadone.
But in the current issue of Network, Martin Wilkinson has written a nice and concise account on the subject... you can read it here. Which gives me a chance to plug Network, which you should all read - it contributes to your CPD, is delivered free if you ask for it, or is of course available to read on line.
