A rapid and reliable method for the quantitation of tricyclic antidepressants in serum using HPLC-MS/MS

High-performance liquid chromatography-tandem mass spectrometry was used to measure 20 antidepressants in human serum

Aim: This study used high performance liquid chromatography-tandem mass spectrometry to quantify the blood concentrations of 20 antidepressants, such as bupropion and fluoxetine, in human serum samples.Methods: After direct precipitation with a 1:9 protein precipitant of methanol and acetonitrile, serum samples were examined using high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS). The material was separated using a Poroshell 120 EC-C18 column (3.0 mm × 50 mm, 2.7 μm) and gradient elution. The mobile phases were phase A 0.01% formic acid aqueous solution (containing 2 mmol/ml ammonium acetate) and phase B methanol solution. A 0.45 ml/min flow rate was used to divide the sample and inject 5 μl. Electrospray ionization source positive ion mode and multiple reaction monitoring modes were used for analysis. Measurement was quantified using an internal standard technique.Results: Accuracy ranged from 90.3 to 114.3%, intra-day precision from 100.1 to 112.3%, inter-day precision from 100.4 to 112.6%, extraction recoveries from 85.5 to 114.5% and matrix effect from 85.6 to 98.7%.Conclusion: This approach is fast, accurate, sensitive and repeatable. It can identify 20 antidepressants in blood simultaneously. This can be used to monitor blood drug levels and medication metabolism.

Improved Pharmacokinetic and Pharmacodynamic Profile of Deuterium-Reinforced Tricyclic Antidepressants Doxepin, Dosulepin, and Clomipramine in Animal Models

BACKGROUND AND OBJECTIVES

Doxepin, dosulepin, and clomipramine are tricyclic antidepressants (TCAs) that act as serotonin and noradrenaline reuptake inhibitors. The metabolites formed by N-dealkylation of these tricyclic antidepressants contribute to overall poor pharmacokinetics and efficacy. Deuteration of the methyl groups at metabolically active sites has been reported to be a useful strategy for developing more selective and potent antidepressants. This isotopic deuteration can lead to better bioavailability and overall effectiveness. The objective is to study the effect of site-selective deuteration of TCAs on their pharmacokinetic and pharmacodynamic profile by comparison with their nondeuterated counterparts.

METHODS

In the current study, the pharmacokinetic profile and antidepressant behavior of deuterated TCAs were evaluated using the forced swim test (FST) and tail suspension test (TST), using male Wistar rats and male Swiss albino mice, respectively; additionally, a synaptosomal reuptake study was carried out.

RESULTS

Compared with the nondeuterated parent drugs, deuterated forms showed improved efficacy in the behavior paradigm, indicating improved pharmacological activity. The pharmacokinetic parameters indicated increased maximum concentration in the plasma (Cmax), elimination half-life (t1/2), and area under the concentration-time curve (AUC)  in deuterated compounds. This can have a positive clinical impact on antidepressant treatment. Synaptosomal reuptake studies indicated marked inhibition of the reuptake mechanism of serotonin (5-HT) and norepinephrine.

CONCLUSIONS

Deuterated TCAs can prove to be potentially better molecules in the treatment of neuropsychiatric disorders as compared with nondeuterated compounds. In addition, we have demonstrated a concept that metabolically active, site-selective deuteration can be beneficial for improving the pharmacokinetic and pharmacodynamic profiles of TCAs. A further toxicological study of these compounds is needed to validate their future clinical use.

Development of Visible Spectrophotometric Methods for the Determination of Tricyclic Antidepressants Based on Formation of Molecular Complexes with p-Benzoquinones

Tricyclic antidepressants are commonly employed in the management of major depressive disorders. The present work describes two visible (VIS) spectrophotometric techniques that utilize the formation of charge transfer complexes between four antidepressant compounds, namely, amitriptyline hydrochloride (AMI), imipramine hydrochloride (IMI), clomipramine hydrochloride (CLO), and trimipramine maleate (TRI) acting as electron donors and two p-benzoquinones, namely, p-chloranilic acid (pCA) and 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ), serving as electron acceptors. The stoichiometry of the compounds produced exhibited a consistent 1:1 ratio in all instances, as established by Job's method. Molar absorptivities, equilibrium association constants, and several other spectroscopic properties were determined for all complexes. The developed spectrophotometric techniques were validated intra-laboratory and successfully applied for quantitative assessment of the four antidepressant active ingredients in several commercial pharmaceutical formulations. The methods are relatively simple, fast, and use readily available laboratory instrumentation, making them easily applicable by most quality control laboratories worldwide.

Role of serum amitriptyline concentration and CYP2C19 polymorphism in predicting the response to low-dose amitriptyline in irritable bowel syndrome

BACKGROUND

Low-dose amitriptyline (AMT) is an effective treatment for diarrhea-dominant irritable bowel syndrome (IBS-D). Its efficacy depends upon its serum concentration and the patient's CYP2C19 genotype.

AIMS

To identify the association between serum AMT and nortriptyline (NT) concentration and CYP2C19 polymorphism and the clinical response in IBS-D patients.

METHODS

Ninety IBS-D patients were treated of AMT for 6 weeks. Efficacy was evaluated by the results of the Adequate Relief question each week and an IBS severity scoring system (IBS-SSS) at 0, 3, and 6 weeks. CYP2C19 genotyping was performed by direct sequencing. AMT and NT steady-state serum concentrations were detected by high-performance liquid chromatography.

RESULTS

The CYP2C19 polymorphism exhibited a significant influence on the NT serum concentration but did not predict the clinical efficacy of AMT for treating IBS-D. The NT steady-state and dose-corrected serum concentrations were significantly correlated with an improvement in the IBS-SSS score after 6 weeks, whereas the AMT serum concentration was not correlated with clinical improvement. The cut-off NT steady-state serum concentration of 2.91 ng/ml may help distinguish responders from non-responders.

CONCLUSIONS

NT serum concentration but not CYP2C19 polymorphism may be correlated with the clinical efficacy of AMT for treating IBS-D, and such a response may occur at the upper NT threshold of 2.91 ng/ml.

Investigating the Utility of Fabric Phase Sorptive Extraction and HPLC-UV-Vis/DAD to Determine Antidepressant Drugs in Environmental Aqueous Samples

Depression is considered to be one of the most prevalent mental disorders in humans. Antidepressant drugs are released in large concentrations and cause adverse effects on the environment and/or human health. Fabric Phase Sorptive Extraction (FPSE), a contemporary solid sorbent-handling technique, is a quick, sensitive, and simple analytical process. This paper describes a micro-extraction FPSE procedure coupled with High-Performance Liquid-Chromatography–Photodiode Array Detection (FPSE-HPLC–DAD) for the simultaneous extraction and analysis of five antidepressants, namely citalopram, clozapine, mirtazapine, bupropion and sertraline. Three fabric media (Whatman Cellulose filter, Whatman Microfiber Glass filter and Polylactic acid disks) and two different sol–gel sorbents (polyethylene glycol (PEG 300), alongside poly(ethylene glycol)-block-poly(propylene glycol)-block-poly(ethylene glycol) (PEG-PPG-PEG 5.800)) were tested. The best FPSE device was observed to be the microfiber glass filter coated with PEG 300 sol–gel sorbent. In addition, the parameters that affect the efficiency of the process (FPSE media and sorbents, sample pH, extraction time, elution time, etc.) were optimized. The proposed methodology displays a linear range with absolute recovery values higher than 60%, RSD% of less than 13% and LOQs in the range between 1.9–10.7 μg·L−1. Finally, the method was applied in hospital and urban effluents and lake water samples, but none of the analytes were detected.

Recent Advances in the HPLC Analysis of Tricyclic Antidepressants in Bio-Samples

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Tricyclic Antidepressants (TCAs) are a group of the main category of antidepressant drugs, which are commonly prescribed to treat major depressive disorder. Determination of TCA drugs is very important for clinical and forensic toxicology, especially for therapeutic drug monitoring in various biofluids. High Performance Liquid Chromatography (HPLC) is a well-established technique for this purpose. A lot of progress has been made in this field since the past 10 years. Novel extraction techniques, and novel materials for sample preparation, novel columns and novel applications of analysis of various biofluids for the determination of TCAs in combination with other drugs are some typical examples. Moreover, advances have been performed in terms of Green Analytical Chemistry principles. Herein, we aim to discuss the developed HPLC methods that were reported in the literature for the time span of 2008-2018.

High Performance Fluorescent Turn-On Probe for Amitriptyline Based on Hybrid Nanoassembly of Organic-Inorganic Nanoparticles

Fluorescence methods have gained enormous attention due to their ease in use, simplicity, selectivity and sensitivity. Fluorescent chemosensors respond instantly by converting molecular recognition to fluorescent signals. The consumption of pharmaceutical products by living beings is on great increase. The disposal of such compounds in the environment is a matter of great concern as these compounds enter aquatic environment and show accumulation in tissues of aquatic organisms. In the present study, we have utilized naphthalimide based receptors to fabricate organic nanoparticles (ONPs). These ONPs were used for the development of hybrid nanoassemblies, and the developed nanoassemblies were characterized with the help of transmission electron microscopy and dynamic light scattering studies. The photophysical studies were performed and the hybrid assembly developed using receptor 2 demonstrated a turn-on fluorescence emission behavior on binding with Amitriptyline. The present sensing system acted as promising candidate for determination of Amitriptyline among other contending drug molecules. The established system can recognize Amitriptyline up to a detection limit of 48 nM in aqueous medium. Electrochemical recognition studies show binding of hybrid nanoassembly of receptor 2 with Amitriptyline with limit of detection of 21 nM.

A simple poly(styrene-co-divinylbenzene)-coated glass blood spot method for monitoring of seven antidepressants using capillary liquid chromatography-mass spectrometry

A simple, rapid, selective and sensitive monitoring method for the simultaneous determination of the widely-prescribed antidepressants agomelatine, bupropion, citalopram, fluoxetine, mirtazapine, paroxetine, trazodone in just a human blood drop is here developed and validated. This methodology is based on the use of lab manufactured poly(styrene-co-divinylbenzene)-coated glass (PS-DVB) blood spot for the extraction of the analytes and their subsequent separation and detection by capillary liquid chromatography-mass spectrometry (CLC-MS). Briefly, 10 mm-side squares were punched out from blood spots collected on glass substrate coated by 10 µg of the PS-DVB polymer and eluted with 1.0 mL of 2.0% acetic acid in methanol. The analytes were then separated and detected in less than 20 min by capillary CLC-MS using a Jupiter 4 µm Proteo 90 Å column and water: acetonitrile (20:80 v/v) and ammonium acetate (5 mM, pH 3.0) as mobile phase. Limit of detection (LOD) ranged from 0.018 to 0.038 µg mL^-1, and remarkable precision values for the responses and retention times lower than 5.89% and 1.92% were calculated, respectively. Moreover, accuracy values ranging between 85% and 104% were obtained.

A high selective and sensitive method for the detection of six psychotropic drugs in human urine by high performance liquid chromatography combined with resonance Rayleigh scattering spectra

A highly selective and sensitive method of high performance liquid chromatography combined with resonance Rayleigh scattering spectra was developed for the detection of six psychotropic drugs: Doxepin, Promethazine, Imipramine, Amitriptyline, Chlorpromazine and Clomipramine.

Effect of a single dose of escitalopram on serotonin concentration in the non-human and human primate brain

Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for treatment of psychiatric disorders. The exact mechanism underlying the clinical effects of SSRIs remains unclear, although increased synaptic serotonin concentrations have been hypothesized to be an initial step. [¹¹C]AZ10419369 is a novel 5-HT(1B) receptor selective radioligand, which is sensitive to changes in endogenous serotonin concentrations. To assess whether a single dose of the SSRI escitalopram affects endogenous serotonin concentrations in serotonergic projection areas and in the raphe nuclei (RN), three cynomolgus monkeys and nine human subjects underwent PET examinations with [¹¹C]AZ10419369 at baseline conditions and after escitalopram administration. In monkeys, the binding potential (BP(ND)) was significantly lower post dose compared to baseline in dorsolateral prefrontal cortex, occipital cortex, thalamus, midbrain and RN (p < 0.05). In humans, the BP(ND) tended to decrease in RN post dose (p = 0.08). In all serotonergic projection areas, the BP(ND) was conversely higher post dose compared to baseline. The increase was significant in a combined region of all projection areas (p = 0.01) and in occipital and temporal cortex (p < 0.05). SSRIs are generally assumed to elevate endogenous serotonin concentrations in projection areas, evoking the antidepressant effect. In the present study, a single, clinically relevant, dose of escitalopram was found to decrease serotonin concentrations in serotonergic projection areas in humans. Hypothetically, desensitization of inhibitory serotonergic autoreceptors will cause the serotonin concentration in projection areas to increase over time with chronic administration. Thus, the findings in the present study might aid in understanding the mechanism of SSRIs' delayed onset of clinical effect.

An introduction to drug testing: the expanding role of mass spectrometry

Measurement of drugs and their metabolites in biological fluids is the foundation of both therapeutic drug monitoring (TDM) and toxicology. Though different in their application, each discipline depends upon accurate identification and quantification if the measurements are to be useful. Thousands of methods are described for drug analysis but until recently most have relied upon analytical tools, such as spectrophotometry and immunoassay, that suffer from lack of specificity and sensitivity. The introduction of methods based on mass spectrometry (MS), coupled to gas or liquid chromatography, has revolutionized these areas. The methods are proving to be robust, versatile, and economical. This chapter introduces the reader to the application of MS to TDM and toxicology, the steps that should be considered during implementation, and the processes that should be implemented to assure continued quality.

Simultaneous determination of nortriptyline hydrochloride and fluphenazine hydrochloride in microgram quantities from low dosage forms by liquid chromatography-UV detection

A novel method for the simultaneous high-performance liquid chromatographic determination of nortriptyline hydrochloride and fluphenazine hydrochloride was developed and validated. Fluvastatin sodium was used as internal standard. The determination was performed on a Hypersil Gold C₈ column (250 mm × 4.6 mm i.d., 5 μm particle size) at 25 °C; the mobile phase, consisting of a mixture of formic acid (0.1 M, pH 2.16)-methanol (33:67, v/v), was delivered at a flow rate of 1.1 mL/min and detector wavelength at 251 nm. The retention time of nortriptyline, fluphenazine and fluvastatin was found to be 5.11, 8.05 and 11.38 min, respectively. Linearity ranges were 5.0–1350.0 and 10.0–1350.0 μg/mL with limit of detection values of 0.72 and 0.31 μg/mL, for nortriptyline and fluphenazine, respectively. Results of assay and recovery studies were statistically evaluated for its accuracy and precision. Correlation coefficients (r²) of the regression equations were greater than 0.999 in all cases. According to the validation results, the proposed method was found to be specific, accurate, precise and could be applied to the simultaneous quantitative analysis of nortriptyline and fluphenazine.