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Tricyclic Antidepressants, Quantitative, Serum or Plasma
2007549
Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Mnemonic
TADQNT SP
Methodology
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Mon, Wed, Fri
Reported
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Timing of specimen collection: Pre-dose (trough) draw - At steady-state concentration. 
Collect
Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA). 
Specimen Preparation
Separate serum or plasma from cells within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL) 
Storage/Transport Temperature
Refrigerated. 
Unacceptable Conditions
Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution). 
Remarks
 
Stability
After separation from cells: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 6 months 
Reference Interval
Effective November 18th, 2013
Drug
Therapeutic Range
Toxic
Amitriptyline (Elavil, Vanatrip)Not establishedNot established
Nortriptyline (Aventyl, Pamelor)50-150 ng/mLGreater than 500 ng/mL
Total Amitriptyline + Nortriptyline95-250 ng/mLGreater than 500 ng/mL
Imipramine (Tofranil)Not establishedNot established
Desipramine (Norpramin)100-300 ng/mLGreater than 500 ng/mL
Total Imipramine + Desipramine150-300 ng/mLGreater than 500 ng/mL
Doxepin (Sinequan, Zonalon)Not establishedNot established
NordoxepinNot establishedNot established
Total Doxepin + Nordoxepin100-300 ng/mLGreater than 500 ng/mL
Protriptyline (Vivactil)70-240 ng/mLGreater than 400 ng/mL
Clomipramine (Anafranil)Not establishedNot established
NorclomipramineNot establishedNot established
Total Clomipramine + Norclomipramine220-500 ng/mLGreater than 900 ng/mL

Interpretive Data


Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note
This test is used to quantitate the following tricyclic antidepressants: amitriptyline, clomipramine, desipramine, doxepin, imipramine, norclomipramine, nordoxepin, nortriptyline, and protriptyline.
Hotline History
N/A
CPT Code(s)
Components
Component Test Code*Component Chart NameLOINC
0090020Amitriptyline/Nortriptyline, Total, SP3335-7
0090024Amitriptyline, SP3333-2
0090065Desipramine, SP3531-1
0090100Doxepin, SP3579-0
0090101Doxepin/Nordoxepin Total, SP3582-4
0090105Nordoxepin, SP3862-0
0090106Protriptyline, SP3999-0
0090135Imipramine/Desipramine Total, SP9627-1
0090139Imipramine, SP3690-5
0090210Nortriptyline, SP3872-9
0099320Clomipramine/Norclomipramine, Total, SP3493-4
0099335Norclomipramine, SP3536-0
0099437Clomipramine (Anafranil), SP3491-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Tricyclic Antidepressant Screen
  • Tricyclic Screen