Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Reliability of Measurements of Tricyclic Levels

Reliability of Measurements of Tricyclic Levels To the Editor.— In regard to the letter "Toxic Tricyclic Antidepressant Levels and the ECG,"1 several remarks are pertinent. In a previous discussion in The Journal,2 the reliability of tricyclic antidepressant serum levels were questioned. The laboratory procedures (gas or liquid chromatography) for measuring tricyclics are complicated, and specimen collection procedures also can be problematic.3 Also, studies using known standards and split samples have revealed troublesome interlaboratory and intralaboratory differences in reporting tricyclic levels.4,5 The patient described by Johnson and associates1 had an initial doxepin level of 1,230 ng/mL with no ECG changes. While it may be correct to conclude that this case is an exception to the "rule" that tricyclic levels over 1,000 ng/mL are associated with QRS prolongation, the alternative possibility of laboratory error must be considered. Another group of investigators using serum spiked with a known quantity of amitriptyline plus nortriptyline have reported http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Reliability of Measurements of Tricyclic Levels

Bank, Robert L.
JAMA , Volume 251 (14) – Apr 13, 1984
Download PDF
1 page

Reliability of Measurements of Tricyclic Levels

Abstract



To the Editor.—
In regard to the letter "Toxic Tricyclic Antidepressant Levels and the ECG,"1 several remarks are pertinent. In a previous discussion in The Journal,2 the reliability of tricyclic antidepressant serum levels were questioned. The laboratory procedures (gas or liquid chromatography) for measuring tricyclics are complicated, and specimen collection procedures also can be problematic.3 Also, studies using known standards and split samples have revealed...
Loading next page...
 
/lp/american-medical-association/reliability-of-measurements-of-tricyclic-levels-HbU0tk0sod

References (7)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1984.03340380019007
Publisher site
See Article on Publisher Site

Abstract

To the Editor.— In regard to the letter "Toxic Tricyclic Antidepressant Levels and the ECG,"1 several remarks are pertinent. In a previous discussion in The Journal,2 the reliability of tricyclic antidepressant serum levels were questioned. The laboratory procedures (gas or liquid chromatography) for measuring tricyclics are complicated, and specimen collection procedures also can be problematic.3 Also, studies using known standards and split samples have revealed troublesome interlaboratory and intralaboratory differences in reporting tricyclic levels.4,5 The patient described by Johnson and associates1 had an initial doxepin level of 1,230 ng/mL with no ECG changes. While it may be correct to conclude that this case is an exception to the "rule" that tricyclic levels over 1,000 ng/mL are associated with QRS prolongation, the alternative possibility of laboratory error must be considered. Another group of investigators using serum spiked with a known quantity of amitriptyline plus nortriptyline have reported

Journal

JAMA – American Medical Association

Published: Apr 13, 1984

There are no references for this article.