Hair analysis of antidepressants and antipsychotics—Overview of quantitative data

Abstract

Antidepressant and antipsychotic drugs are regularly encountered in different aspects of forensic toxicology, and some cases require the examination of hair samples. In this study, common antidepressant and antipsychotic drugs regarding hair concentrations over the past decades were reviewed. Although numerous publications around method validations, case reports, or controlled dose studies were found, apparently there is a lack of comprehensive data for many substances. Information on the hair length and dosage across the publications varied largely, and case numbers were generally low except for several retrospective controlled dose studies. Many substances were described only in method validations or case reports, and data were obtained from small case numbers. On the contrary, clozapine, haloperidol, amitriptyline, nortriptyline, risperidone and its metabolite, methylphenidate, citalopram, chlorpromazine, chlorprothixene, and quetiapine had a well‐founded database as these substances were investigated in controlled dose studies with higher case numbers. Given the advancements made in analytical techniques over the past years, gas chromatography–mass spectrometry and liquid chromatography with tandem mass spectrometry techniques were the methods of choice and allowed the detection of chemical compounds at low concentrations. The controversy around a potential use of hair analysis to estimate the dosage remains as dose‐concentration studies provided divergent results. A harmonization on the investigated hair length as well as on the extraction protocol would be of favor to achieve better comparability. Although hair analysis research focused mainly on drug abuse, availability of more data on antidepressants and antipsychotics would help to gain better knowledge and assist other forensic investigators.

Detection of Methylphenidate in Equine Hair Using Liquid Chromatography–High-Resolution Mass Spectrometry

“…As equine hair on the mane and tail grows at ≈2–3 cm per month, this offers a reproducible sampling location with the ability to have repeated sampling occur from the sample animal at various time points [ 16 , 17 ]. The exact mechanism for incorporation of various drugs, including methylphenidate into hair is not fully understood, but in general, basic compounds more readily partition into hair as compared to acidic compounds [ 7 , 9 , 18 , 19 ]. Prior to implementing hair testing into official samples, one should consider the length of hair collected and length of segments (if desired), which influences the time period of drug coverage.…”

“…Analysis of hair samples offers an alternative sampling matrix that can extend the potential detection window following the administration of a prohibited substance [ 7 ]. There have been several reports of the detection of methylphenidate in the hair of humans associated with either therapeutic use or abuse of the compound using either gas chromatography–mass spectrometry (GC-MS) or liquid chromatography–mass spectrometry (LC-MS) [ 8 , 9 , 10 , 11 , 12 ]. The increased sensitivity afforded by modern LC-MS equipment as compared to older GC-MS-based technology has made low-level detections (≈0.5 pg/mg) of methylphenidate possible, although many investigators only monitored the presence of a single product ion (84 m/z ).…”

Evidence of repeated mirtazapine poisoning in children by hair analysis

“…antidepressants published in 2020, Methling et al [19] have summarized major findings and obviously, mirtazapine concentrations are generally below 1 ng/mg. Other authors [20][21][22][23][24] are listed in Table 2.…”

A Systematic Review of Metabolite-to-Drug Ratios of Pharmaceuticals in Hair for Forensic Investigations

“…MD ratios of drugs of abuse in hair have frequently been reported [10][11][12][13], but the literature is still very limited regarding pharmaceuticals in hair. Despite this, a wide range of pharmaceuticals is commonly encountered in postmortem and forensic toxicology cases [14,15]. The limited information on such drugs, their metabolites, and the related MD ratio makes it difficult to interpret and compare hair analysis results and to eventually evaluate drug intake.…”