Sign in →

Test Code LABDESPR Desipramine, Serum

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
DESIPRAMINE LABDESPR DESPR DESPR

 

Useful For

Monitoring serum concentration during therapy

 

Evaluating potential toxicity

 

The test may also be useful to evaluate patient compliance

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Desipramine, S

Specimen Type

Serum Red


Specimen Required


Container/Tube: Red top

Specimen Volume: 1 mL

Collection Instructions:

1. Draw specimen immediately before next scheduled dose (minimum 12 hours after last dose).

2. Serum must be separated from cells within 2 hours of draw.


Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  7 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross reject

Other

Serum gel tube

Clinical Information

Desipramine is a tricyclic antidepressant; it also is a metabolite of imipramine. These drugs have also been employed in the treatment of enuresis (involuntary urination) in childhood and severe obsessive-compulsive neurosis. Desipramine is the antidepressant of choice in patients where maximal stimulation is indicated.

 

The therapeutic concentration of desipramine is 100 to 300 ng/mL. About 1 to 3 weeks of treatment are required before therapeutic effectiveness becomes apparent.

 

The most frequent side effects are those attributable to anticholinergic effects: dry mouth, constipation, dizziness, tachycardia, palpitations, blurred vision, and urinary retention. These occur at blood concentrations in excess of 400 ng/mL, although they may occur at therapeutic concentrations in the early stage of therapy. Cardiac toxicity (first-degree heart block) is usually associated with blood concentrations in excess of 400 ng/mL.

Reference Values

Therapeutic concentration: 100-300 ng/mL

 

Note: Therapeutic ranges are for specimens drawn at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens.

Interpretation

Most individuals display optimal response to desipramine with serum levels of 100 to 300 ng/mL. Some individuals may respond well outside of this range, or may display toxicity within the therapeutic range; thus, interpretation should include clinical evaluation. Risk of toxicity is increased with levels above 400 ng/mL.

Cautions

This test cannot be performed on whole blood. Serum must be separated from cells within 2 hours of drawing; if serum is not removed within this time, tricyclic antidepressant levels may be falsely elevated due to drug release from RBCs. Specimens that are obtained from gel tubes are also not acceptable, as the drug can absorb on the gel and lead to falsely decreased concentrations.

Method Description

The tricyclic antidepressants are extracted from serum using a solvent crash to precipitate proteins. The supernatant is remove and analysis is by liquid chromatography-tandem mass spectrometry (LC-MS/MS).(Unpublished Mayo method)

Day(s) and Time(s) Performed

Monday through Saturday; Varies

Analytic Time

2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

80335

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DESPR Desipramine, S 3531-1

 

Result ID Test Result Name Result LOINC Value
37123 Desipramine, S 3531-1