Cristina Buzatu Georgiana, Isac Sebastian, Teodorescu Geani-Danut, Isac Teodora, Martac Cristina, Cobilinschi Cristian, Pavel Bogdan, Andreescu Cristina Veronica, Droc Gabriela
Department of Anesthesiology and Intensive Care I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Internal Medicine II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Life (Basel). 2025 Jul 10;15(7):1084. doi: 10.3390/life15071084.
Methadone, a synthetic opioid used for opioid substitution therapy (OST), is typically associated with arrhythmias rather than direct myocardial depression. Neurological complications, especially with concurrent antipsychotic use, have also been reported. Acute left ventricular failure in young adults is uncommon and often linked to genetic or infectious causes. We present a rare case of reversible cardiogenic shock and cerebellar insult due to methadone toxicity.
A 37-year-old man with a history of drug abuse on OST with methadone (130 mg/day) was admitted to the ICU with hemodynamic instability, seizures, and focal neurological deficits. Diagnostic workup revealed low cardiac output syndrome and a right cerebellar insult, attributed to methadone toxicity. The patient received individualized catecholamine support. After 10 days in the ICU, he was transferred to a general ward for ongoing cardiac and neurological rehabilitation and discharged in stable condition seven days later.
Methadone-induced reversible left ventricular failure, particularly when accompanied by cerebellar insult, is rare but potentially life-threatening. Early recognition and multidisciplinary management are essential for full recovery in such complex toxicological presentations.
美沙酮是一种用于阿片类药物替代疗法（OST）的合成阿片类药物，通常与心律失常相关，而非直接导致心肌抑制。也有报道称存在神经并发症，尤其是在同时使用抗精神病药物的情况下。年轻成年人急性左心室衰竭并不常见，且通常与遗传或感染原因有关。我们报告一例罕见的因美沙酮中毒导致可逆性心源性休克和小脑损伤的病例。
一名37岁有药物滥用史且正在接受美沙酮（130毫克/天）阿片类药物替代疗法的男性因血流动力学不稳定、癫痫发作和局灶性神经功能缺损入住重症监护病房（ICU）。诊断检查显示为低心输出量综合征和右侧小脑损伤，归因于美沙酮中毒。患者接受了个体化的儿茶酚胺支持治疗。在ICU治疗10天后，他被转至普通病房继续进行心脏和神经康复治疗，7天后病情稳定出院。
美沙酮诱发的可逆性左心室衰竭，尤其是伴有小脑损伤时，虽然罕见但可能危及生命。对于此类复杂的毒理学表现，早期识别和多学科管理对于完全康复至关重要。
