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HelpTest Code CLOM Clomipramine, Serum
Useful For
Determining whether a poor therapeutic response is attributable to noncompliance
Monitoring serum concentration of clomipramine and norclomipramine to assist in optimizing the administered dose
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Clomipramine, SSpecimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
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 a plastic vial. Serum must be separated from cells within 2 hours of collection.
Specimen Minimum Volume
0.25
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 7 days |
Reference Values
Clomipramine and norclomipramine
Therapeutic concentration: 230-450 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.
Interpretation
Studies investigating the relationship between serum concentrations of clomipramine and norclomipramine and therapeutic response have yielded conflicting results. However, the probability of therapeutic failure seems to increase if the sum of the clomipramine and norclomipramine serum concentrations is less than 230 ng/mL. Summed serum concentrations of clomipramine and norclomipramine that exceed 450 ng/mL seem to result in no additional enhancement in therapeutic response and may predispose the patient to greater risk of adverse side effects. A toxic range has not been well established at this time.
Clinical Reference
1. Wille SM, Cooreman SG, Neels HM, Lambert WE. Relevant issues in the monitoring and the toxicology of antidepressants. Crit Rev Clin Lab Sci. 2008;45(1):25-89
2. Thanacoody HK, Thomas SHL. Antidepressant poisoning. Clin Med (Lond). 2003;3(2):114-118
3. Hiemke C, Bergemann N, Clement HW, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018;51:9-62
4. Milone MC, Shaw LM. Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453
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
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CLOM | Clomipramine, S | 43127-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 80902 | Clomipramine | 3491-8 |
| 7983 | Norclomipramine | 3536-0 |
| 7984 | Clomipramine + Norclomipramine | 3493-4 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.