Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: We appreciate the discussion by Dr
Krantz and colleagues of the emerging data regarding methadone's effect on
the QT interval and the occurrence of torsades de pointes.
In response to all of these letters, we would like to clarify that we
purposely sought experts' advice on selected medications with respect to whether
the experts would measure the QT interval on an ECG before and after initiating
these drugs. This information is summarized in the Box in our article. Among
the considerations in this advice are not only objective data in the literature
but also the practicality and cost-effectiveness of such an approach. We sought
to understand how experts assimilate the available literature, despite its
inconsistencies, with their professional experience and how they translate
this into practice recommendations.
Al-Khatib SM, Allen LaPointe NM, Kramer JM, Califf RM. Medications That Prolong the QT Interval. JAMA. 2003;290(8):1025. doi:10.1001/jama.290.8.1025-a