Specimen:

Serum

Collection Medium:

Alternate
Collection Media:

Call laboratory for additional acceptable specimen collection 
containers.

Minimum:

5 mL in red top tube or two red top microtubes

Rejection Criteria:

Gel separator tubes.

Testing
Schedule:

24 hrs/day, 7 days a week, including holidays.

Analytic Time:

3 hours (upon receipt in laboratory)

Reference Range:

Positive result:  Possible toxic concentration > or = to 300 ng/ml
Negative result:  None or therapeutic concentration < 300 ng/ml

Comments:

Semiquantitative non-specific immunological test for toxicological 
detection of TCA exposure.  It will detect primarily the four major 
TCA's:  Amitriptylline, Nortriptyline, Imipramine and Desipramine.  
Samples containing other TCA's, phenothiazines, or drugs structurally 
related to TCA may show interference in the assay.

Test
Limitations:

The Tricyclic Antidepressants assay is primarily for the detection of 
the four major TCA: Amitriptyline, nortriptyline, imipramine and 
desipramine.  Applicability of the assay to other TCA must be 
interpreted based upon their relative cross-reactivities.  Refer to the 
Specificity section in this assay insert for additional information.  
The concentration reading of a serum or plasma sample is only an 
estimation of the total amount of TCA and their demethylated 
metabolites present.  Accurate quantitation of total TCA or individual 
TCA should be determined by a confirmatory assay methodology such as 
HPLC or GC.  Samples containing toxic concentrations of phenothiazines 
such as perphenazine, or other drugs structurally related to TCA, such 
as cyclobenzaprine, may show interference in the assay.  Seroquel, 
Clozaril, Ludiomil and Remeron have been shown to cross-react.

Methodology:

Fluorescent Polarization ImmunoAssay (FPIA)

Sample
Processing:

Centrifuge at 3000 RPM for 10 minutes.
Aliquot serum into labeled container and cap.
Label transport tube with two patient identifiers, date and time of 
collection.

Sample
Storage:

Room temperature or refrigerate if stored overnight, weekends or 
holidays.

Transport
Instructions:

Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Ship ambient or refrigerate.

CPT Code:

80101

See also:
Drugs of Abuse Screen, Urine

See Additional Information:
Chemistry Critical Lab Values