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HelpTest ID TRMP Trimipramine, Serum
Specimen Required
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Collect specimen immediately before next scheduled dose (minimum 12 hours after last dose).
2. Centrifuge and aliquot serum into plastic vial. Serum must be separated from cells within 2 hours of collection.
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Useful For
Monitoring trimipramine concentration during therapy
Evaluating potential trimipramine toxicity
May aid in evaluating patient compliance
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Trimipramine, SSpecimen Type
Serum RedSpecimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 7 days |
Clinical Information
Trimipramine is a tricyclic antidepressant with additional anxiety-reducing sedative activity. Daily dosages for adults range from 50 mg to 300 mg and are usually divided into 2 to 3 doses per day. Therapeutic ranges are based on serum samples collected at trough (ie, immediately before the next dose). Peak serum concentrations are typically achieved after 1 to 6 hours post dosage.
Common adverse effects include hypotension, tachycardia, constipation, dizziness, somnolence, and blurred vision. Risk of toxicity increases when concentrations exceed 500 ng/mL. Serious adverse effects include coma, seizures, and QRS prolongation with ventricular dysrhythmias.
Reference Values
Therapeutic concentration: 150-300 ng/mL
Note: Therapeutic ranges are for specimens collected at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens.
Cautions
This test cannot be performed on whole blood. Serum must be separated from cells within 2 hours of collection; if serum is not removed within this time, tricyclic antidepressant levels may be falsely elevated due to drug release from red blood cells.
Specimens that are obtained from gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.
Coadministration of fluvoxamine, moclobemide, or quinidine inhibits the metabolism and markedly increases the serum concentrations of trimipramine.
Day(s) Performed
Tuesday, Thursday, Sunday
Report Available
3 to 5 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80335
G0480 (if appropriate)