Evaluation of the Abbott ADx total serum tricyclic immunoassay.
The ADx total serum tricyclic antidepressant (TCA) fluorescence polarization immunoassay (Abbott Diagnostics) for the semi-quantitation of imipramine or amitriptyline and their respective N-demethylated metabolites in cases of TCA overdose was evaluated. The assay is linear from 75-1000 ng/mL total TCA in serum, and flaggs as "HI" all results exceeding 300 ng/mL. The within and between run precision of the assay for patient serum containing imipramine or amitriptyline and their metabolites gave CV's of less than 5.5% and 8.9%, respectively. A good correlation between the results of patient serum containing imipramine and desipramine simultaneously analyzed by ADx and gas liquid chromatography (GC) was observed, r2 = 0.964, n = 32. Results of patient serum containing amitriptyline and nortriptyline or doxepin and desmethyldoxepin analyzed by ADx and GC or GC-mass spectrometry were not well correlated; r2 = 0.738, n = 44 and r2 = 0.695, n = 21, respectively. The assay consistently flagged as "HI" serum with total imipramine and desipramine concentrations above 300 ng/mL by GC, and serum with greater than 360 ng/mL of amitriptyline and nortriptyline by GC/MS. No significant cross-reactivity was observed for drugs other than the TCA.
Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond.
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Poklis
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Soghoian
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Crooks
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Saady
D000929:Antidepressive Agents, Tricyclic / Q000097:blood*; D002849:Chromatography, Gas; D005069:Evaluation Studies as Topic; D015200:Fluoroimmunoassay / Q000379:methods*; D006801:Humans; D007202:Indicators and Reagents
D000929:Antidepressive Agents, Tricyclic; D007202:Indicators and Reagents