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A false positive for clozapine using high-pressure liquid chromatography with ultraviolet detection

Published online by Cambridge University Press:  24 June 2014

Unax Lertxundi ,
Margarita H. Manrique ,
Saioa D. Echaburu  and
Manuel Martinez
Unax Lertxundi*
Affiliation:
Pharmacy Service, Red de Salud Mental de Araba, C/alava 43, 01006 Vitoria-Gasteiz, Araba, Spain
Margarita H. Manrique
Affiliation:
Communitary Rehabilitation Centre, Red de Salud Mental de Araba, C/reyes católicos 6, 01006 Vitoria-Gasteiz, Araba, Spain
Saioa D. Echaburu
Affiliation:
Pharmacy Service, Hospital Alto Deba, Avda, Nafarroa 16, 20500 Arrasate Gipuzkoa, Spain
Manuel Martinez
Affiliation:
Reference Laboratory S.A., Barcelona, Spain
*
Unax Lertxundi, Pharmacy Service, Red de Salud Mental de Araba, C/alava 43, 01006 Vitoria-Gasteiz, Araba, Spain. Tel: +34 945 00 65 33; Fax: +34 945 00 65 87; E-mail: Unax.lertxundietxebarria@osakidetza.net
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Extract

Background: We report a case of a false positive for clozapine, when analysing serum levels using a high-pressure liquid chromatography with ultraviolet (HPLC-UV) detection method.

Methods: A patient not taking clozapine tested positive for clozapine three times in two different samples. This false positive was discovered by chance, because of an administrative error made in the first analytic test request.

Results: The analysis of the first sample with a more specific method [HPLC-tandem mass spectrometry (LC-MS/MS)] showed that no clozapine was present.

Conclusions: It is important to acknowledge that depending on the method employed, a false positive should not be ruled out as a possibility. Moreover, and even more worryingly, it should also be taken into account that clozapine serum levels could be tested erroneously high if the unknown interference is present and the HPLC-UV method is used. Although the interfering compound could not be identified, the possibility of a cross-reaction when analysing serum clozapine levels with the HPLC-UV method warrants urgent attention.

Keywords

clozapinedrug monitoringfalse-positive reactions
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 24 , Issue 4 , August 2012 , pp. 245 - 246
Copyright
Copyright © Cambridge University Press 2012

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References

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