Purpose
Exclusion Screen
Method(s)
Gas Chromatography (GC)
Suggested CPT Code(s)
80307
New York State Approval Status

Approved

Known Interference(s)
Protriptyline [GC]: Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)
Turnaround Time

5 days (If Positive: 12 days)

Test Includes
1 Amitriptyline Elavil®; Endep® Gas Chromatography (GC) ng/mL 50 Antidepressant
2 Nortriptyline Amitriptyline Metabolite; Aventyl®; Pamelor® Gas Chromatography (GC) ng/mL 50 Antidepressant
3 Clomipramine Anafranil® Gas Chromatography (GC) ng/mL 50 Antidepressant
4 Desmethylclomipramine Clomipramine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
5 Imipramine Tofranil® Gas Chromatography (GC) ng/mL 50 Antidepressant
6 Desipramine Imipramine Metabolite; Norpramin®; Pertofrane® Gas Chromatography (GC) ng/mL 50 Antidepressant
7 Doxepin Sinequan® Gas Chromatography (GC) ng/mL 50 Antidepressant
8 Desmethyldoxepin Doxepin Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
9 Trimipramine Surmontil® Gas Chromatography (GC) ng/mL 50 Antidepressant
10 Desmethyltrimipramine Trimipramine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
11 Fluoxetine Prozac® Gas Chromatography (GC) ng/mL 50 Antidepressant
12 Norfluoxetine Fluoxetine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
13 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 50 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)
14 Maprotiline Ludiomil® Gas Chromatography (GC) ng/mL 50 Antidepressant
15 Trazodone Desyrel® Gas Chromatography (GC) mcg/mL 0.1 Antidepressant
16 Amoxapine Asendin® Gas Chromatography (GC) ng/mL 50 Antidepressant
17 Mirtazapine Remeron® Gas Chromatography (GC) ng/mL 50 Antidepressant

Test Also Known As
Adapin®; Rhotrimine®; Triptil®
Reflex Tests
Test Code Test Name
5450U Antidepressants Confirmation, Urine
Specimen Type
Urine
Requested Volume
3 mL
Minimum Volume
1.4 mL
Special Handling
None
Specimen Container
Plastic container (preservative-free)

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
None

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: 7 day(s)
Refrigerated: 11 day(s)
Frozen (-20 °C): 14 day(s)
1 Amitriptyline Elavil®; Endep® Gas Chromatography (GC) ng/mL 50 Antidepressant
2 Nortriptyline Amitriptyline Metabolite; Aventyl®; Pamelor® Gas Chromatography (GC) ng/mL 50 Antidepressant
3 Clomipramine Anafranil® Gas Chromatography (GC) ng/mL 50 Antidepressant
4 Desmethylclomipramine Clomipramine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
5 Imipramine Tofranil® Gas Chromatography (GC) ng/mL 50 Antidepressant
6 Desipramine Imipramine Metabolite; Norpramin®; Pertofrane® Gas Chromatography (GC) ng/mL 50 Antidepressant
7 Doxepin Sinequan® Gas Chromatography (GC) ng/mL 50 Antidepressant
8 Desmethyldoxepin Doxepin Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
9 Trimipramine Surmontil® Gas Chromatography (GC) ng/mL 50 Antidepressant
10 Desmethyltrimipramine Trimipramine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
11 Fluoxetine Prozac® Gas Chromatography (GC) ng/mL 50 Antidepressant
12 Norfluoxetine Fluoxetine Metabolite Gas Chromatography (GC) ng/mL 50 Antidepressant
13 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 50 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)
14 Maprotiline Ludiomil® Gas Chromatography (GC) ng/mL 50 Antidepressant
15 Trazodone Desyrel® Gas Chromatography (GC) mcg/mL 0.1 Antidepressant
16 Amoxapine Asendin® Gas Chromatography (GC) ng/mL 50 Antidepressant
17 Mirtazapine Remeron® Gas Chromatography (GC) ng/mL 50 Antidepressant

Interface Map

LOINC® Information