title: Hair testing in clinical setting: Simultaneous determination of 50 psychoactive drugs and metabolites in headache patients by LC tandem MS.
abstract: Headache patients suffering from recurrent attacks are a population at risk of overuse and abuse of analgesic medications. Associated with triptans, the first-line drugs recommended for the acute treatment, these patients usually take other medications such as opioids analgesics for the attack treatment, antidepressants and antiepileptics for prophylaxis treatment and benzodiazepines, non-benzodiazepine hypnotics and antipsychotics for the treatment of comorbidities. Regular and frequent use of triptans, like of any other symptomatic analgesic, can cause chronic headache and medication-overuse headache (MOH). In these circumstances, a detoxification treatment is necessary and therefore the monitoring and follow-up of the patients are crucial to the success of the treatment. In the present study, a LC tandem MS method has been developed for the identification of 50 psychoactive drugs in human hair, including triptans, benzodiazepines and metabolites, analgesics, antiepileptic, antidepressants and metabolites, a non-benzodiazepine hypnotic (z-drug), antipsychotics and metabolites. Hair samples were decontaminated, pulverized and incubated overnight in methanol; the extracts were then purified by a new and rapid QuEChERS procedure and analyzed by LC-MS/MS under gradient elution with positive ionization MRM mode. The procedure was fully validated in terms of selectivity, linearity, limit of detection and lower limit of quantitation, precision and accuracy, carry-over, matrix effect, recovery and dilution integrity. The validated procedure has been applied to 234 real hair samples collected from headache patients with known type and dosage of the taken drugs; the obtained data could be of interest to evaluate the xenobiotic concentrations in patients with known therapy.
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy. Electronic address: manuela.licata@unimore.it.
authors.forename: Manuela
authors.initials: M
authors.lastname: Licata
authors.affiliation: Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi, 103, 41125 Modena, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Rustichelli
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Palazzoli
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Toxicology and Clinical Pharmacology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ferrari
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Toxicology and Clinical Pharmacology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Baraldi
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Vandelli
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Verri
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Marchesi
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Silingardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002853:Chromatography, Liquid / Q000379:methods*; D005260:Female; D006197:Hair / Q000737:chemistry*; D006261:Headache / Q000188:drug therapy; D006801:Humans; D057230:Limit of Detection; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000032:analysis* / Q000627:therapeutic use; D015203:Reproducibility of Results; D053719:Tandem Mass Spectrometry / Q000379:methods*; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: HPLC–MS/MS; Hair samples; Headache patients; Psychoactive drugs; QuEChERS