Rapid Simultaneous Determination of 14 Antidepressants and 13 Antipsychotics in Human Plasma by Using High-Performance Liquid Chromatography–Tandem Mass Spectrometry With Dynamic Multiple Reaction Monitoring and Its Application to Therapeutic Drug Monitoring. Issue 4 (August 2021)

• Record Type: Journal Article
• Authors: Lyu, Haiyan; Chen, Binbin; Xu, Xiangzhen; Zhu, Chunyan; Ma, Chunling; Du, Yu; Liu, Farong; Wu, Caisheng
• Is Part Of: Therapeutic drug monitoring. Volume 43:Issue 4(2021)
• Publication Date: 2021-08
• Subjects: antidepressants -- antipsychotics -- HPLC-MS/MS -- TDM -- dynamic multiple reaction monitoring -- supra–alert-level samples; Pharmacokinetics -- Periodicals; Patient monitoring -- Periodicals; Drugs -- Analysis -- Periodicals; Body fluids -- Analysis -- Periodicals; Drug Therapy -- Periodicals; Monitoring, Physiologic -- Periodicals; Pharmacology -- Periodicals; 615.7
• DOI: 10.1097/FTD.0000000000000839
• Languages: English
• ISSNs: 0163-4356

Abstract

Abstract : Background: A comprehensive, stable, and efficient high-performance liquid chromatography–tandem mass spectrometry method was developed for rapidly analyzing 14 antidepressants and 13 antipsychotics in human plasma for routine clinical therapeutic drug monitoring. Methods: Simple protein precipitation was used for the pretreatment of plasma samples; dynamic multiple reaction monitoring was used to avoid the loss of sensitivity caused by numerous ion transitions. In all, 80 ion transitions of 40 compounds were quantitatively determined in 6 minutes. Results: The limit of detection for the 27 analytes was in the range of 0.1–30 ng/mL, and all calibration lines prepared using blank plasma were linear with a correlation coefficient of r 2 ≥ 0.99. The method was accurate and precise with acceptable intraday and interday precisions (coefficients of variation, ⩽20% for a lower limit of quantification and ⩽15% for other quality control samples) and an accuracy of 85.51%–114.77%. This analysis method has been completely validated and successfully used in routine clinical therapeutic drug monitoring for more than 9963 samples [including 488 samples having drug concentrations above the laboratory alert level (supra–alert-level samples)] at Xiamen Xianyue Hospital. Conclusions: This dynamic method is comprehensive (includes most antidepressants and antipsychotics listed in China), reliable (stably used for almost 2 years), and efficient (convenient sample processing and short run time) and provides a large amount of meaningful data for optimized pharmacotherapy. Our experimental data from the plasma concentrations of supra–alert-level samples could serve as a reference for the interpretation of the pharmacokinetics of patients with a high risk of toxicity or loss of tolerability. Abstract : Supplemental Digital Content is Available in the Text.