Test Code IMIPR Imipramine and Desipramine, Serum
Useful For
Monitoring imipramine and desipramine concentrations during therapy
Evaluating potential imipramine and desipramine toxicity
May aid in evaluating patient compliance
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Imipramine and Desipramine, 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 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum Red | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 7 days |
Reference Values
Imipramine and Desipramine
Total therapeutic concentration: 175-300 ng/mL
Desipramine
Therapeutic concentration: 100-300 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.
Interpretation
Most individuals display optimal response to imipramine when combined serum levels of imipramine and desipramine are between 175 and 300 ng/mL. Risk of toxicity is increased with levels above 400 ng/mL.
Most individuals display optimal response to desipramine with serum levels of 100 to 300 ng/mL. Risk of toxicity is increased with desipramine levels above 400 ng/mL.
Some individuals may respond well outside of these ranges or may display toxicity within the therapeutic range; thus, interpretation should include clinical evaluation.
Therapeutic ranges are based on specimen collected at trough (ie, immediately before the next dose).
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 RochesterTest 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 |
---|---|---|
IMIPR | Imipramine and Desipramine, S | 43123-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
63508 | Imipramine | 3690-5 |
37121 | Desipramine | 3531-1 |
37122 | Imipramine and Desipramine | 9627-1 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Cardiovascular Test Request Form (T724)
-Therapeutics Test Request (T831)