Methadone-induced bilateral severe sensorineural hearing loss

Vorasubin, Nopawan; Calzada, Audrey; Ishiyama, Akira

doi:10.1016/j.amjoto.2013.08.011

Cited by 18 publications

(25 citation statements)

References 12 publications

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“…Most cases have involved either heroin [8–14] or hydrocodone/acetaminophen [15–18] with varying degrees of recovery. Recently, four case reports have described acute SSHL in five patients upon awaking from coma or stupor induced by acute methadone overdose [1–4] (Table 1). Although it is difficult to prove causality of methadone for the SSHL, the time course is a compelling indication that methadone may be the cause.…”

Section: Discussionmentioning

confidence: 99%

Methadone Induced Sensorineural Hearing Loss

Saifan

Glass

Barakat

et al. 2013

Case Reports in Medicine

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Background. Sudden sensorineural hearing loss (SSHL) caused by opiate abuse or overuse has been well documented in the medical literature. Most documented case reports have involved either heroin or hydrocodone/acetaminophen. Recently, case reposts of methadone induced SSHL have been published. Case Report. We present the case of a 31-year-old man who developed SSHL after a methadone overdose induced stupor. He was subsequently restarted on methadone at his regular dose. On follow-up audiometry exams, he displayed persistent moderately severe sensorineural hearing loss bilaterally. Discussion. This case is notable because unlike all but one previously reported case, the patient—who was restated on methadone—did not make a complete recovery. Conclusion. Methadone overuse in rare cases causes SSHL.

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Section: Discussionmentioning

confidence: 99%

Methadone Induced Sensorineural Hearing Loss

Saifan

Glass

Barakat

et al. 2013

Case Reports in Medicine

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“…The common side effects of methadone are well-described and include sedation, constipation, respiratory depression, lightheadedness, dizziness, nausea, and vomiting. Other side effects include dysrhythmias, itching, sweating, and orthostatic hypotension (1–4).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported the impacts of methadone as an ototoxic medication on auditory system but most of these studies were case reports (2–4, 8, 18). The clinical findings have suggested that methadone administration could lead to both reversible and irreversible hearing loss.…”

Section: Introductionmentioning

confidence: 99%

“…To the best of our knowledge, all of the published reports on methadone associated hearing loss were case reports and there is no clinical trials conducted on a sample of patients with a control group. We could find six case reports published on hearing loss after methadone overdose or abuse (2–4, 18). Of them, four cases were reported to show speedy and fully recovery and only two case reports showed persistent hearing loss (4, 8).…”

Section: Introductionmentioning

confidence: 99%

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Early Diagnosis of Hearing Loss in Patients Under Methadone Maintenance Treatment

et al. 2019

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Background and Objective: Methadone maintenance treatment (MMT) as the most effective treatment for opioid addictions could induce both reversible and permanent hearing loss. Therefore, early detection of methadone-induced hearing loss is necessary to prevent irreversible cochlear damage. The present study aims to identify the early onset of hearing loss in patients who underwent MMT and to compare them with the age and gender matched normal hearing peers. Methods: This was an analytic cross-sectional study conducted on patients ( n = 27 males; age range: 18–53 years old) who received 3 months MMT course (MMT group) and a control group consisting of age and gender matched healthy individuals ( n = 27 males). Before MMT, all patients underwent conventional audiometry (250–8,000 Hz) and those with normal hearing threshold participated into the study. One month after MMT termination, the patients were assessed for possible hearing loss using conventional pure tone audiometry (PTA), extended high frequency (EHF) audiometry, and distortion product otoacoustic emissions (DPOAEs). Results: Our results demonstrated that the mean EHF thresholds in the MMT patients were significantly greater than the age- and gender-matched healthy controls across all frequencies ( p < 0.001). However, there was no statistically significant difference in conventional PTA thresholds between both groups ( p > 0.05). DPOAE amplitudes significantly reduced at higher frequencies (3,000–8,000 Hz) in the MMT group, compared to the healthy control group. In contrast to the conventional PTA audiometry, the EHF and DPOAE assessments identified hearing impairments in 11 (40.74%), and 14 (51.85%) of the MMT patients, respectively. The main mechanisms proposed for methadone induced hearing loss are cochlear ischemia following vasospasm or vasculitis, direct effect of opioids on opioid receptors present in cochlear stria vascularis of inner ear, blood-labyrinth selective transport of opioidproteins and receptors, and genetic polymorphism and mutations. Conclusion: The EHF and DPOAE tests have the potential to detect earlier changes in auditory function than conventional frequency audiometry in the MMT patients.

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“…One of these drugs is methadone. Six recent case reports exposed an unknown before side effect of methadone abuse-the hearing loss [51][52][53][54][55]. The patients described in reports were young (age range 20-37) and were admitted to the hospitals because of methadone overuse.…”

Section: Methadonementioning

confidence: 99%

Ototoxicity: Old and New Foes

Szczepek¹

2017

Advances in Clinical Audiology

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Drug-induced ototoxicity has been known for centuries. Already in the seventeenth century, hearing loss was described to be a side effect of quinine. The post-World War II pharmaceutical industry boomed with the production of aminoglycoside antibiotics followed by diuretics and cytostatic drugs. Wide-spread and long-term usage of these medications brought the knowledge about their unwanted ototoxic effects. In the last decades, several new drugs appeared on the shelves of pharmacies and the hearing loss or tinnitus have been among the side effects of many of them. However, the awareness of community about new ototoxic medications is still not sufficient. New ototoxic drugs may belong to the class of phosphodiesterase-5 (PDE5) inhibitors, used to improve microcirculation and to treat erectile dysfunction. Moreover, interferons used for the therapy of hepatitis B and C, common painkiller paracetamol and hydrocodone, synthetic opioid methadone and the inhibitors of reverse transcriptase were demonstrated to induce adverse effects on hearing. Lastly, hearing loss linked to immunosuppressive drugs was documented in patients undergoing organ transplantation. Making the patients aware of adverse drug reactions and offering them audiological monitoring and intervention should be considered by respective therapists.

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Methadone-induced bilateral severe sensorineural hearing loss

Cited by 18 publications

References 12 publications

Methadone Induced Sensorineural Hearing Loss

Methadone Induced Sensorineural Hearing Loss

Early Diagnosis of Hearing Loss in Patients Under Methadone Maintenance Treatment

Ototoxicity: Old and New Foes

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