Sudden toxicity of methadone in monkeys: behavioral and electrophysiological evidence.

A sudden and potentially lethal toxic reaction to a previously well-tolerated maintenance dose of methadone occurred in 4 of 6 monkeys. The reaction was characterized by gross behavioral and respiratory depression and a marked attenuation of both early and late components of the visual evoked response with an increase in most latencies. The nature of the evoked response alteration suggests a widespread central nervous system depressant effect of the drug during toxicity. Concomitant with the toxic reactions were dramatic increases in plasma methadone concentrations. Therefore the observed changes in sensitivity to methadone would appear to be the consequence of a sudden shift in pharmacokinetics resulting in toxic plasma concentrations.