Drug level monitoring: antidepressants

The determination of antidepressant drugs which act by blocking neuronal uptake of biogenic amines, because of their widespread use and high toxicity, remains one of the most commonly requested drug assays in clinical laboratories. Easy to use immunoassay reagents for the estimation of these drugs are commercially available. However, immunoassays have not been universally accepted because of high probability of these reagents producing false negative and false positive results. At present, column liquid chromatography with absorbance detection and coupled with solid-phase extraction is the most viable technique for a general procedure for the identification and determination of these drugs. The technique of liquid chromatography is economical, environmental friendly since water-miscible and biodegradable solvents can be used for extraction of drugs and their chromatographic separation, and amenable to full automation. New techniques of separation, such as supercritical fluid chromatography and capillary zone electrophoresis, have not yet been applied for the determination of therapeutic concentrations of antidepressants.