Substitution of (R,S)-methadone by (R)-methadone: Impact on QTc interval.

Methadone is administered as a chiral mixture of (R,S)-methadone. The opioid effect is mainly mediated by (R)-methadone, whereas (S)-methadone blocks the human ether-à-go-go-related gene (hERG) voltage-gated potassium channel more potently, which can cause drug-induced long QT syndrome, leading to potentially lethal ventricular tachyarrhythmias. To investigate whether substitution of (R,S)-methadone by (R)-methadone could reduce the corrected QT (QTc) interval, (R,S)-methadone was replaced by (R)-methadone (half-dose) in 39 opioid-dependent patients receiving maintenance treatment for 14 days. (R)-methadone was then replaced by the initial dose of (R,S)-methadone for 14 days (n = 29). Trough (R)-methadone and (S)-methadone plasma levels and electrocardiogram measurements were taken. The Fridericia-corrected QT (QTcF) interval decreased when (R,S)-methadone was replaced by a half-dose of (R)-methadone; the median (interquartile range [IQR]) values were 423 (398-440) milliseconds (ms) and 412 (395-431) ms (P = .06) at days 0 and 14, respectively. Using a univariate mixed-effect linear model, the QTcF value decreased by a mean of -3.9 ms (95% confidence interval [CI], -7.7 to -0.2) per week (P = .04). The QTcF value increased when (R)-methadone was replaced by the initial dose of (R,S)-methadone for 14 days; median (IQR) values were 424 (398-436) ms and 424 (412-443) ms (P = .01) at days 14 and 28, respectively. The univariate model showed that the QTcF value increased by a mean of 4.7 ms (95% CI, 1.3-8.1) per week (P = .006). Substitution of (R,S)-methadone by (R)-methadone reduces the QTc interval value. A safer cardiac profile of (R)-methadone is in agreement with previous in vitro and pharmacogenetic studies. If the present results are confirmed by larger studies, (R)-methadone should be prescribed instead of (R,S)-methadone to reduce the risk of cardiac toxic effects and sudden death.

The timing and interval of mate encounter affects investment during mating

The benefits obtained from mating are usually condition-dependent, favouring the evolution of flexible investment during copulation, for instance, in terms of invested time, energy, or sperm. Flexible investment strategies are predicted to depend on the likelihood of acquiring alternative mates and therefore they should depend on the timing of mate encounter. However, scarce experimental evidence for this hypothesis exists. Here we manipulated the time delay until first mating and the interval between first and second mating in the polygynandrous common lizard, Zootoca vivipara. We determined treatment effects on fertilisation success and copulation duration, the latter being a proxy for investment in mating and for quantity of transferred sperm. The duration of the second copulation decreased with increasing inter-mating interval and depended on the fertilisation success of first mates. The former provides evidence for time-dependent investment strategies, most likely resulting from the progression of the female's reproductive cycle. Fertilisation success of first mates increased with increasing inter-mating interval and was higher when females were closer to ovulation, showing that flexible investment strategies significantly affected male reproductive success. This points to fertilisation assurance, which may mitigate negative effects of low population density on reproductive success, e.g. Allee effects.