Ordering Recommendation

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Random urine.

Specimen Preparation

Transfer 2 mL urine to an ARUP standard transport tube. (Min: 0.7 mL)
Test is not performed at ARUP; separate specimens must be submitted when multiple tests are ordered.

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Unacceptable Conditions
Remarks
Stability

Ambient: 1 week; Refrigerated: 11 days; Frozen: 2 weeks

Methodology

Quantitative Gas Chromatography/Gas Chromatography-Mass Spectrometry (GC-MS)

Performed

Varies

Reported

4-7 days

Reference Interval

Interpretive Data



Compliance Category

Performed by non-ARUP Laboratory

Note

Panel includes: Amitriptyline, amoxapine, clomipramine, desmethylclomipramine, desipramine, doxepin, desmethyldoxepin, desmethyltrimipramine, fluoxetine, norfluoxetine, imipramine, maprotiline, mirtazapine, nortriptyline, protriptyline, trazodone, and trimipramine.

Desmethylsertraline (sertraline metabolite) and norcyclobenzaprine (cyclobenzaprine metabolite) are known interferences for protriptyline.

Hotline History

N/A

CPT Codes

80332; 80337; 80338 (Alt code: G0480)

Components

Component Test Code* Component Chart Name LOINC
0090602 Amitriptyline 16114-1
0090603 Nortriptyline 3875-2
0090604 Desipramine 3534-5
0090605 Doxepin 3581-6
0090606 Desmethyldoxepin 12386-9
0090608 Imipramine 3692-1
0090614 Maprotiline 3738-2
0090620 Protriptyline 26978-7
0090621 Clomipramine 3492-6
0090622 Desmethylclomipramine 18470-5
0090623 Trimipramine 12443-8
0090624 Desmethyltrimipramine 12444-6
0090641 Fluoxetine 12439-6
0090642 Norfluoxetine 12445-3
0090643 Trazodone 27059-5
0090644 Amoxapine 3343-1
0090647 Mirtazapine 49690-1
* 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

  • Adapin
  • Amitriptyline Metabolite
  • Anafranil
  • Asendin
  • Aventyl
  • Clomipramine Metabolite
  • Desyrel
  • Doxepin Metabolite
  • Elavil
  • Endep
  • Fluoxetine Metabolite
  • Imipramine Metabolite
  • Ludiomil
  • Norpramin
  • Pamelor
  • Pertofrane
  • Prozac
  • Remeron
  • Rhotramine
  • Sinequan
  • Surmontil
  • Tofranil
  • Tricyclics
  • Trimipramine Metabolite
  • Triptil
  • Vivactil
Antidepressant Panel Quantitative, Urine

National Medical Services (NMS)