Abstract
Methadone is the most used opiate drug in opiate addiction therapy and there are recent indications of its nephrotoxicity. The most likely mechanism of action of methadone is increasing muscle demand for oxygen, which causes the muscle to act as if it is in ischemia, which consequently leads to myoglobin release and destruction of tubules by myoglobin products breakdown. Rhabdomyolysis occurs, and as a result acute renal failure is possible. In addition, methadone is also more potent in causing rhabdomyolysis if in concomitant use with benzodiazepines. In this paper, we present a case of a 35-year-old opiate addict on withdrawal therapy. Following methadone and concomitant Benzodiazepine abuse the patient developed rhabdomyolysis and epileptic seizures. We further discuss the methadone nephrotoxicity as well as therapeutic options for rhabdomyolysis caused by methadone poisoning. Methadone is the standard therapy for opiate addiction. However, it cannot be considered to be a completely safe drug. It is vital to raise awareness about the risks of rhabdomyolysis, among physicians, in patients undergoing methadone therapy. Timely diagnosis and an adequate therapeutic response can be vital for the patient.
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