False-positive drug test results in patients taking psychotropic drugs. A literature review

Masternak, Sebastian; Padała, Olga; Karakuła-Juchnowicz, Hanna

doi:10.12740/pp/113173

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Cross-reactivity to multiple fentanyl analogs is a desirable feature of screening and presumptive assays. However, false positives could be caused by known cross-reactivity to other non-opioids drugs like ziprasidone and risperidone, which share a core structure similar to fentanyl [31][32][33]. To solve this problem, one possible solution is to build a de-selection strategy into the antibody discovery process.…”

Section: Discussionmentioning

confidence: 99%

Rapid and Highly Sensitive Detection of Fentanyl and its Analogs by a Novel Chemiluminescence Immunoassay

Zhao,

Uddin,

Unsihuay

et al. 2023

Preprint

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A highly sensitive immunoassay with sub-picogram limit of detection for fentanyl and a wide range of fentanyl analogs has been developed, using a novel high affinity antibody fused with NanoLuc, a small-size luciferase that can emit strong and stable luminescence. When applied to unaltered clinical human urine samples, the assay has sub-picogram limit of detection for fentanyl, with results fully concordant with gold standard liquid chromatography-mass spectrometry. When applied to environmental samples, the assay can detect as low as 0.25 pg fentanyl per inch2environment surface. Assay turn-around-time is less than 1 hour, with inexpensive equipment needed and potential for high throughput automation or in-field screening. This novel assay has broad potential applications in clinical, environmental, occupational and forensic scenarios by detecting trace amount of fentanyl and its analogs to keep frontline workers safe.

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Section: Discussionmentioning

confidence: 99%

Rapid and Highly Sensitive Detection of Fentanyl and its Analogs by a Novel Chemiluminescence Immunoassay

Zhao,

Uddin,

Unsihuay

et al. 2023

Preprint

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“…In clinical settings, TCA screening assays have historically had a high rate of false positives [ 8 ]. Moreover, the similarities between the clinical symptoms of diphenhydramine and TCA intoxication mean that medical doctors may misdiagnose patients and administer the wrong treatment [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Diphenhydramine Intoxication With Blood Extended Half-Life and a False Positive Result for Tricyclic Antidepressants

Yokoyama,

Kaizaki-Mitsumoto,

Numazawa

et al. 2024

Cureus

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Diphenhydramine is a first-generation antihistamine medication. Acute intoxication with diphenhydramine can be severe and potentially fatal. The current case is of a 13-year-old girl who presented with central nervous system depression after voluntary intake of unknown drugs. Serum concentration analysis showed diphenhydramine intoxication, blood half-life extension, and a false positive result for tricyclic antidepressants (TCAs) in urine examination. To our knowledge, this is the first reported case of confirmed diphenhydramine overdose with a false positive result for TCAs and measurement of the serum level in a child. Considering the similarities between the clinical symptoms of diphenhydramine and TCA intoxication, this case illustrates that all physicians should consider the possibility of cross-reactivity during the diagnosis of patients with unknown acute drug intoxication who test positive for TCAs.

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Rapid and Sensitive Detection of Fentanyl and Its Analogs by a Novel Chemiluminescence Immunoassay

Zhao,

Uddin,

Unsihuay

et al. 2024

Clinical Chemistry

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Background Abuse of fentanyl and its analogs is a major contributor to the opioid overdose epidemic in the United States, but detecting and quantifying trace amounts of such drugs remains a challenge without resorting to sophisticated mass spectrometry-based methods. Methods A sensitive immunoassay with a sub-picogram limit of detection for fentanyl and a wide range of fentanyl analogs has been developed, using a novel high-affinity antibody fused with NanoLuc, a small-size luciferase that can emit strong and stable luminescence. When used with human urine samples, the assay has a sub-picogram limit of detection for fentanyl, with results fully concordant with LC-MS. Results When applied to clinical samples, the novel chemiluminescence immunoassay can detect low positive fentanyl missed by routine screening immunoassays, with a limit of detection of 0.8 pg/mL in human urine. When applied to environmental samples, the assay can detect levels as low as 0.25 pg fentanyl per inch2 of environment surface. Assay turnaround time is less than 1 h, with inexpensive equipment and the potential for high-throughput automation or in-field screening. Conclusions We have established a novel assay that may have broad applications in clinical, environmental, occupational, and forensic scenarios for detection of trace amounts of fentanyl and its analogs.

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False-positive drug test results in patients taking psychotropic drugs. A literature review

Cited by 3 publications

References 42 publications

Rapid and Highly Sensitive Detection of Fentanyl and its Analogs by a Novel Chemiluminescence Immunoassay

Rapid and Highly Sensitive Detection of Fentanyl and its Analogs by a Novel Chemiluminescence Immunoassay

Diphenhydramine Intoxication With Blood Extended Half-Life and a False Positive Result for Tricyclic Antidepressants

Rapid and Sensitive Detection of Fentanyl and Its Analogs by a Novel Chemiluminescence Immunoassay

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