OVERVIEW

Purpose: Detection and quantification of amitriptyline, desipramine, doxepin, desmethyldoxepin, imipramine, nortriptyline, citalopram, n-desmethylcitalopram, fluoxetine, paroxetine, sertraline, venlafaxine, o-desmethylvenlafaxine, mcpp, trazodone, mirtazapine and desmethylmirtazapine in urine.

CLINICAL INFORMATION

Tricyclic Antidepressants
This test includes amitriptyline (Elavil/Endep), desipramine (Norpramin/Petrofrane), doxepin (Adapin/Sinequan), imipramine (Tofranil), nortriptyline (Pamelor/Aventyl/Norpress) and their primary metabolites. These medications are commonly prescribed for major depressive disorder (depression). Tricyclic antidepressants, when taken in high doses, can be toxic to the heart and brain, emphasizing the importance of monitoring patient adherence to prescribed dosage. The panel serves as a valuable tool for clinical monitoring of compliance with antidepressant therapy.

Serotonergic Antidepressants
This test includes citalopram (Celexa/Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor/Pristiq) and their primary metabolites. These medications are commonly prescribed for major depressive disorder (depression) and various anxiety disorders. High doses of these medications can lead to a range of side effects. The panel is valuable for clinical monitoring of compliance with antidepressant therapy.

Trazodone
Trazodone (Desyrel) is a common antidepressant prescribed for major depressive disorder (depression) and various anxiety disorders. It can be ordered alone or combined with other antidepressant panels for a broader assessment of antidepressant use.

mCPP
This test measures a hallucinogen, mCPP, which is a known adulterant in “ecstasy” pills. This drug is known to cause unpleasant effects and is not commonly desired for recreational use. However, it has been known to appear in “ecstasy” pills and therefore may be tested in connection with MDMA. Additionally, mCPP is a minor metabolite of the antidepressant trazodone (Desyrel). Ordering this test together with trazodone testing may be useful in interpreting false positives for mCPP.

Citalopram
Citalopram (Celexa/Lexapro) is a commonly prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant. It can be ordered alone or combined with other antidepressant panels to provide a comprehensive assessment of antidepressant use. Citalopram is frequently prescribed for major depressive disorder (depression) and various anxiety disorders. These medications have a broad range of known side effects, particularly at high doses. The panel is valuable for clinical monitoring of adherence to antidepressant therapy.

SPECIMEN COLLECTION

Specimen Type: Random Urine
Preferred Collection Container: Non-sterile specimen container
Specimen Required: 3 mL urine; minimum 1 mL

TEST DETAILS

Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Compliance Category: Laboratory Developed Test (LDT)
This test was developed and assessed by DMD in compliance with CLIA requirements for its analytical performance characteristics and clinical application. This test has not been cleared or approved by the U.S. Food and Drug Administration.
Reference Interval: Negative
Drug/Metabolite Tested:
Drug/Metabolite Cutoff concentration 500 ng/mL
Amitriptyline 50 ng/mL
Desipramine 50 ng/mL
Doxepin 100 ng/mL
Desmethyldoxepin 100 ng/mL
Imipramine 50 ng/mL
Nortriptyline 50 ng/mL
Citalopram 50 ng/mL
N-Desmethylcitalopram 100 ng/mL
Fluoxetine 100 ng/mL
Paroxetine 25 ng/mL
Sertraline 50 ng/mL
Venlafaxine 100 ng/mL
O-Desmethylvenlafaxine 100 ng/mL
Meta-Chlorophenylpiperazine: 50 ng/mL
Trazodone 50 ng/mL
Mirtazapine 100 ng/mL
Desmethylmirtazapine 100 ng/mL
CPT code(s): 80336, 80333, 80371, 80338, 80335
Turnaround Time: 90% < 48 hours, 50% < 24 hours

SPECIMEN PROCESSING

Transport Temperature: Refrigerated (preferred) or room temperature overnight shipping.
Specimen Stability: 3 days at room temperature and 14 days at refrigerated and frozen temperatures (to be further confirmed with our validation).
Rejection Criteria: Stability limits exceeded.

Director: Cheryl Hanau, MD; Donald Hall Jr., PhD; Garth Ehrlich, PhD; Yinghua Qiu, PhD, DABCC

Review Date: 08/28/2023

Note: The billing party has sole responsibility for CPT coding. Any questions regarding coding should be directed to the payer being billed. The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

 
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