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- W2029382246 abstract "To the Editor.— In regard to the letter Toxic Tricyclic Antidepressant Levels and the ECG, 1 several remarks are pertinent. In a previous discussion inThe Journal, 2 the reliability of tricyclic antidepressant serum levels were questioned. The laboratory procedures (gas or liquid chromatography) for measuring tricyclics are complicated, and specimen collection procedures also can be problematic. 3 Also, studies using known standards and split samples have revealed troublesome interlaboratory and intralaboratory differences in reporting tricyclic levels. 4,5 The patient described by Johnson and associates 1 had an initial doxepin level of 1,230 ng/mL with no ECG changes. While it may be correct to conclude that this case is an exception to the rule that tricyclic levels over 1,000 ng/mL are associated with QRS prolongation, the alternative possibility of laboratory error must be considered. Another group of investigators using serum spiked with a known quantity of amitriptyline plus nortriptyline have reported" @default.
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- W2029382246 date "1984-04-13" @default.
- W2029382246 modified "2023-09-26" @default.
- W2029382246 title "Reliability of Measurements of Tricyclic Levels" @default.
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- W2029382246 doi "https://doi.org/10.1001/jama.1984.03340380019007" @default.
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