False-Positive Results in the Detection of Methadone in Urines of Patients Treated with Psychotropic Substances

Lancelin, F.; Kraoul, L.; Flatischler, Nadia; Brovedani-Rousset, Sophie; Piketty, Marie-Liesse

doi:10.1373/clinchem.2005.055350

Cited by 17 publications

(14 citation statements)

References 10 publications

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“…The potential for psychotropic medications to cause false-positive results for methadone was also evaluated. 10 Kinetics Interaction of Microparticles in Solution (KIMS, Roche), a monoclonal antibody assay, identified possible false-positive results for chlorpromazine, clomipramine, and thioridazine. No cross-reactivity was found for other typical antipsychotics (trifluoperazine, fluphenazine, loxapine) or atypical antipsychotic agents (clozapine, olanzapine, risperidone).…”

Section: Reports Of False-positive Results Of Urine Drug Screens For mentioning

confidence: 99%

“…Results from such tests should be confirmed using additional analytical methods, including gas chromatographymass spectrometry. Examples of specific medications with false-positive reports are listed in Table 1 and included brompheniramine, 6,7 bupropion, 8,9 chlorpromazine, 10,11 clomipramine, 10 dextromethorphan, [12][13][14] diphenhydramine, 11,15 doxylamine, 16 ibuprofen, 14 naproxen, 4 promethazine, 17 quetiapine, 5,18,19 quinolones 1,3 (ofloxacin 20 and gatifloxacin 21 ), ranitidine, 22,23 sertraline, 24,25 thioridazine, 10 trazodone, 26 venlafaxine, [27][28][29] verapamil, 2 and a nonprescription nasal inhaler. 30 Amphetamine or methamphetamine was the most commonly reported false-positive UDS result.…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Commonly prescribed medications and potential false-positive urine drug screens

Brahm¹,

Yeager²,

Fox³

et al. 2010

American Journal of Health-System Pharmacy

121

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Section: Reports Of False-positive Results Of Urine Drug Screens For mentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Commonly prescribed medications and potential false-positive urine drug screens

Brahm¹,

Yeager²,

Fox³

et al. 2010

American Journal of Health-System Pharmacy

121

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“…False-positive results for methadone have been reported with other techniques and were attributable to metabolites of verapamil, diphenhydramine and doxylamine (Lancelin 2005).…”

Section: Methadonementioning

confidence: 96%

“…In individuals where methadone is not prescribed but EDDP is detected, or in those thought to be nonadherent and adding methadone to their urine, specimens need to be screened for the presence of both methadone and EDDP. It is therefore important to indicate whether or not methadone is prescribed, or if adulteration of urine specimen by the individual is suspected (Lancelin 2005).…”

Section: Opioid Drug Screensmentioning

confidence: 99%

Testing for illicit drug use in mental health services

Abraham¹,

Luty²

2010

Adv. psychiatr. treat

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SummaryTesting for illicit drug use is used in pre-employment checks, the criminal justice system, sports medicine and for screening and confirmatory purposes in patients with physical and mental illnesses. The types of drugs tested for and the methods used vary depending on the indication. This article focuses primarily on blood, urine and oral fluids, which are specimens more commonly used in mental health settings, although hair and sweat are increasingly used in medico-legal cases and in child protection issues. The main drugs and their metabolism are discussed to gain a better understanding of the methods used and for accurate interpretation. Methods to ensure validity during sample collection are explored. False-positive and false-negative tests are common and possible confounders are discussed.

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“…La quetiapine, neuroleptique qui n'est pas commercialisé en France [23], certains métabolites du vérapamil [24], certains neuroleptiques comme la cyamémazine, la lévomépromazine et l'alimémazine [25], la diphénydramine [26] et enfin la doxylamine [27] semblent pouvoir donner des réactions faussement positives.…”

Section: Les Recherches En Immunoanalyseunclassified

Le dépistage immunochimique des médicaments substitutifs de l'héroïne et autres opioïdes

Alvarez

2009

Ann Toxicol Anal

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Résumé -Selon l'Observatoire Français des Drogues et Toxicomanie, en 2007, de 12 000 à 15 000 patients étaient traités par méthadone et plus de 80 000 par buprénorphine. Pouvoir effectuer un dépistage rapide de ces deux molécules par immunoanalyse est donc important, aussi bien pour vérifier la compliance, obligatoire pour les patients traités par méthadone, que dans un cadre médico-légal où ces molécules sont retrouvées dans plus de 8 % des recherches de causes de décès. De nombreuses études ont été publiées à ce jour sur les différents tests commercialisés. Ceux-ci sont le plus souvent validés pour un usage dans les urines, mais également dans le sang total, le plasma, le sérum, la salive et/ou les cheveux en ce qui concerne les kits ELISA. Les seuils de positivité varient de 5 à 300 ng/mL pour la méthadone et de 0,5 à 5 ng/mL pour la buprénorphine en fonction des tests et des matrices biologiques. Dans les cheveux, les seuils proposés sont de l'ordre de 200 pg/mg pour la méthadone et de 10 pg/mg pour la buprénorphine. L'EDDP, principal métabolite de la méthadone, ne croise pas avec l'anticorps dirigé contre la méthadone, mais il existe des tests spécifiques pour l'EDDP. Pour la buprénorphine, les taux de croisement avec la norbuprénorphine varient de 1 à 100 %. Différentes molécules fréquemment prescrites comme le vérapamil, certains neuroleptiques, la diphénydramine et la doxylamine peuvent parfois donner des résultats faussement positifs avec les tests méthadone et le tramadol ou la dihydrocodéine avec ceux pour la buprenorphine. Plus récemment, des tests d'immunoanalyse permettant la recherche des nouveaux opioïdes utilisés en thérapeutique et ne croisant pas ou partiellement avec la recherche classique des opiacés ont été développés. C'est le cas notamment du dextropropoxyphène, de l'oxycodone et du fentanyl. Ces tests, sur lesquels relativement peu d'études sont encore disponibles, peuvent s'avérer intéressants dans certains cas. Mots clés : Immunoanalyse, méthadone, buprénorphine, traitements de substitution, opioïdesAbstract -In France in 2007, between 12 000 and 15 000 patients were treated by methadone and more than 80 000 by buprenorphine. A rapid detection of these two compounds has to be available for the monitoring of these patients, or in forensic cases since these compounds are found in more than 8% of the deceases. Many studies were published on the different marketed tests. All these tests were validated in urine, but many of them, notably ELISA tests, were also validated in whole blood, serum, plasma, oral fluid or hair. The used cut-offs were in the range 5-300 ng/mL for methadone and 0.5-5 ng/mL for buprenorphine depending on the tests and the matrix. In hair, the proposed cut-offs were 200 pg/mg for methadone and 10 pg/mg for buprenorphine. The cross-reactivity of EDDP, the main metabolite of methadone, is very low, but some tests used a specific antibody for this metabolite. The cross-reactivity of norbuprenorphine, the main metabolite of buprenorphine, is in the range 1-100%. False-posi...

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False-Positive Results in the Detection of Methadone in Urines of Patients Treated with Psychotropic Substances

Cited by 17 publications

References 10 publications

Commonly prescribed medications and potential false-positive urine drug screens

Commonly prescribed medications and potential false-positive urine drug screens

Testing for illicit drug use in mental health services

Le dépistage immunochimique des médicaments substitutifs de l'héroïne et autres opioïdes

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