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  • Immunoassay reagents intended to perform qualitative and/or quantitative analyses on a body fluid sample (e.g., serum) to determine one or more of a group of drugs that stimulates the mood of a depressed patient (i.e., antidepressants). The most frequently administered antidepressants contain three fused rings in their chemical structure (i.e., tricyclic antidepressants). They include amitryptiline, desipramine, doxepin, imipramine, and nortriptyline. Some tetracyclic drugs are also used as antidepressants. Reagents used to determine antidepressant concentration in blood differentiate therapeutic levels (typically very low) from toxic levels due to overdose. Tricyclic antidepressant concentration in serum is directly related to therapeutic response, with the exception of nortriptyline which has a specific therapeutic window (typically 50 to 150 nanograms/milliliter). The metabolism of tricyclic antidepressants, especially their hydroxylation, results in the formation of active metabolites, which contribute to both the therapeutic and the adverse effects of these compounds.
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