Tricyclic Antidepressants, Quantitative, Serum or Plasma

Casandra

Casandra Test Code AR89896Version 1 (DRAFT)

Performing Lab

Lab ARUP LaboratoriesLab Test ID 2007549CPT Codes 0480, 80337

Tricyclic Antidepressants, Quantitative, Serum or Plasma

Also known as: TADQNT SP

Clinical Use

Order Test

Use

This test is used to optimize dosing and monitor patient adherence for tricyclic antidepressants. It measures the concentration of several common tricyclic antidepressants and their metabolites in serum or plasma to ensure therapeutic levels are achieved and to avoid toxicity. The test provides therapeutic and toxic concentration ranges for drugs like amitriptyline, nortriptyline, imipramine, and their respective metabolites, helping to guide treatment adjustments for optimal efficacy and safety.

Special Instructions

For accurate test results, it's crucial to collect the specimen as a predose (trough) draw at the steady-state concentration of the medication. Serum or plasma must be separated from cells within 2 hours of collection to ensure sample integrity, and whole blood or certain types of collection tubes like gel separators are not acceptable.

Limitations

Therapeutic ranges are not established for all tricyclic antidepressants in this test, and urine concentrations do not correlate with clinical effects or toxicity. This test is not FDA cleared or approved but is developed for clinical use in a CLIA-certified laboratory. It may not detect all metabolites or forms of the drugs depending on the individual patient's metabolism and other factors.

Test Details

New York Approved

Methodology

Mass Spectrometry

Biomarkers

9 targets

AmitriptylineClomipramineDesipramineDoxepinImipramineNorclomipramineNordoxepinNortriptyline+1 more

LOINC Codes

Order Codes

3335-7
3333-2
3531-1
3579-0
3582-4
3862-0
3999-0
9627-1
3690-5
3872-9
3493-4
3536-0
3491-8

Result Turnaround Time

2-8 days

Specimen

Serum

Volume

1 mL

Minimum Volume

0.5 mL

Container

ARUP standard transport tube

Collection Instructions

Timing of specimen collection: Predose (trough) draw at steady-state concentration. Plain red tube or lavender (K2 or K3EDTA) or pink (K2EDTA) tube is acceptable.