title: A comparison of five commercial immunoassays for the detection of flunitrazepam and other benzodiazepines in urine.
abstract: Five commercially available immunoassay test kits (SYVA EMIT(R) d.a.u(TM), SYVA EMIT(R) II assay, Abbott FPIA, Cozart Auto-Lyte(R) and Roche Abuscreen(R) Online(TM), all used for the benzodiazepine group of drugs) were evaluated for their ability to detect flunitrazepam, its major urinary metabolite, 7-aminoflunitrazepam, and several other benzodiazepines at serial dilutions (final concentration 25-1000 ng/ml) in drug-free urine and in urines following oral administration of flunitrazepam (1-3 mg). For comparison, gas chromatography/mass spectrometry was used to measure urinary levels of 7-aminoflunitrazepam. Levels of drug detected in the study were compared with the cross-reactivities presented by the manufacturers for each individual kit. One to three mg doses of flunitrazepam were taken by volunteers and levels excreted in urine analysed over several hours. A positive response was obtained in several samples from volunteers who had taken 2 mg or 3 mg doses, but not a 1 mg dose. Thirty-five clinical samples from the individuals suspected of benzodiazepine abuse were also examined. The results were not consistent among the kits evaluated.We conclude that the test kits evaluated in this study do not detect flunitrazepam reliably, due primarily to their poor sensitivities.
authors.affiliation: Department of Medical Microbiology, University College, Dublin, Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: Barrett
authors.forename: K
authors.initials: K
authors.lastname: Walshe
authors.forename: P V
authors.initials: PV
authors.lastname: Kavanagh
authors.forename: S M
authors.initials: SM
authors.lastname: McNamara
authors.forename: C
authors.initials: C
authors.lastname: Moran
authors.forename: J
authors.initials: J
authors.lastname: Burdett
authors.forename: A G
authors.initials: AG
authors.lastname: Shattock