title: Quantification of Tricyclic Antidepressants in Serum Using Liquid Chromatography Electrospray Tandem Mass Spectrometry (HPLC-ESI-MS/MS).
abstract: Tricyclic antidepressants (TCA) are used to treat major depressive disorder and other psychological conditions. The efficacy of these drugs is tied to a narrow therapeutic window. Inappropriately high drug concentrations can result in serious side effects such as hypotension, tachycardia, or coma. As a result, concentrations of tricyclic antidepressants are routinely monitored to ensure compliance and to prevent adverse side effects by dose adjustments. We describe a method for the determination of concentrations of amitriptyline, desipramine, imipramine, and nortriptyline in human serum using high-performance liquid chromatography coupled to a tandem mass spectrometer with electrospray ionization (HPLC-ESI-MS/MS). The method is rapid, requiring only 3.5 min per analysis. The method requires 100 μL of serum. Concentrations of each TCA were quantified by a calibration curve relating the peak area ratio of each TCA analyte to a deuterated internal standard (amitriptyline-D3, desipramine-D3, imipramine-D3, and nortriptyline-D3). The method was linear from ~70 ng/mL to ~1000 ng/mL for all TCAs, with imprecision ≤ 12%.
authors.affiliation: Department of Pathology, The Johns Hopkins University School of Medicine, Meyer B-125, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Crutchfield
authors.affiliation: Department of Pathology, The Johns Hopkins University School of Medicine, Meyer B-125, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: Autumn R
authors.initials: AR
authors.lastname: Breaud
authors.affiliation: Department of Pathology-Clinical Chemistry, The Johns Hopkins University School of Medicine, Meyer B-125, 600 N. Wolfe Street, Baltimore, MD, 21287, USA. wclarke@jhmi.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Clarke
mesh_terms: D000639:Amitriptyline / Q000097:blood*; D000929:Antidepressive Agents, Tricyclic / Q000097:blood*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D003891:Desipramine / Q000097:blood*; D006801:Humans; D007099:Imipramine / Q000097:blood*; D009661:Nortriptyline / Q000097:blood*; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods*; D053719:Tandem Mass Spectrometry / Q000379:methods*
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D009661:Nortriptyline; D007099:Imipramine; D003891:Desipramine
keywords: Amitriptyline; Depression; Desipramine; Imipramine; Nortriptyline; Tandem mass spectrometer; Tricyclic antidepressants