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Amitriptyline 423

Includes metabolite nortriptyline.

CPT Code(s): 80152

Specimen Container:

Red-top (no gel) tube
Sodium or Lithium heparin (green-top) tubes are acceptable.

Preferred Specimen:

3 mL serum (1.5 mL minimum)

Instructions:

Collect at steady-state trough concentration. Specimen should be collected > 12 hrs after dose. Do not use gel barrier/Serum Separator tubes.

Transport Temperature:

Room temperature

Specimen Stability:

Room temperature: 5 days
Refrigerated: 7 days
Frozen: Not Established

Reject Criteria:

Gross hemolysis: Gel barrier/Serum Separator tubes

Methodology:

Liquid Chromatography Tandem Mass Spectrometry

Reference Range:

Total 100 - 250 mcg/L

Clinical Use:

Amitriptyline is a tricyclic antidepressant used in the treatment of depressive disorders. The drugs are useful in treatment of autonomous or endogenous depressions. Characteristics of these depressions are a lack of responsibilities to environmental events or interpersonal interactions, along with such symptoms as loss of appetite, anergia, anhedonia, decreased productivity and disturbances of sleep, sexual drive and motor activity. Amitriptyline is metabolized to nortriptyline, which is also an active tricyclic antidepressant. Side effects are primarily anticholinergic consisting of dry mouth, epigastric distress, constipation, palpitations, blurred vision, urinary retention, tachycardia and hypotension. Toxicity can lead to arrhythmias, coma and death.