Tricyclic Antidepressants, Quantitative, Serum or Plasma
Ordering Recommendation
Use to optimize dosing and monitor patient adherence.
New York DOH Approval Status
Specimen Required
Timing of specimen collection: Predose (trough) draw at steady-state concentration.
Plain red. Also acceptable: Lavender (K2 or K3EDTA) or pink (K2EDTA).
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)
Refrigerated.
Whole blood. Gel separator tubes, light blue (citrate), or yellow (SPS or ACD solution).
After separation from cells: Ambient: 5 days; Refrigerated: 2 weeks; Frozen: 6 months
Methodology
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Fri
Reported
2-8 days
Reference Interval
| Drug |
Therapeutic Range |
Toxic |
|---|---|---|
| Amitriptyline (Elavil, Vanatrip) | Not established | Not established |
| Nortriptyline (Aventyl, Pamelor) | 50-150 ng/mL | Greater than 500 ng/mL |
| Total Amitriptyline + Nortriptyline | 95-250 ng/mL | Greater than 500 ng/mL |
| Imipramine (Tofranil) | Not established | Not established |
| Desipramine (Norpramin) | 100-300 ng/mL | Greater than 500 ng/mL |
| Total Imipramine + Desipramine | 150-300 ng/mL | Greater than 500 ng/mL |
| Doxepin (Sinequan, Zonalon) | Not established | Not established |
| Nordoxepin | Not established | Not established |
| Total Doxepin + Nordoxepin | 100-300 ng/mL | Greater than 500 ng/mL |
| Protriptyline (Vivactil) | 70-240 ng/mL | Greater than 400 ng/mL |
| Clomipramine (Anafranil) | Not established | Not established |
| Norclomipramine | Not established | Not established |
| Total Clomipramine + Norclomipramine | 220-500 ng/mL | Greater than 900 ng/mL |
Interpretive Data
Urine concentrations of tricyclic antidepressants do not correlate with signs or symptoms of therapy or toxicity. Therapeutic ranges are not established.
Laboratory Developed Test (LDT)
Note
This test is used to quantitate the following tricyclic antidepressants: amitriptyline, clomipramine, desipramine, doxepin, imipramine, norclomipramine, nordoxepin, nortriptyline, and protriptyline.
Hotline History
Hotline History
CPT Codes
80337 (Alt code: G0480)
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0090020 | Amitriptyline/Nortriptyline, Total, SP | 3335-7 |
| 0090024 | Amitriptyline, SP | 3333-2 |
| 0090065 | Desipramine, SP | 3531-1 |
| 0090100 | Doxepin, SP | 3579-0 |
| 0090101 | Doxepin/Nordoxepin Total, SP | 3582-4 |
| 0090105 | Nordoxepin, SP | 3862-0 |
| 0090106 | Protriptyline, SP | 3999-0 |
| 0090135 | Imipramine/Desipramine Total, SP | 9627-1 |
| 0090139 | Imipramine, SP | 3690-5 |
| 0090210 | Nortriptyline, SP | 3872-9 |
| 0099320 | Clomipramine/Norclomipramine, Total, SP | 3493-4 |
| 0099335 | Norclomipramine, SP | 3536-0 |
| 0099437 | Clomipramine (Anafranil), SP | 3491-8 |
Aliases
- Tricyclic Antidepressant Screen
- Tricyclic Screen
















