Magnetic solid-phase extraction coupled with UHPLC-MS/MS for four antidepressants and one metabolite in clinical plasma and urine samples.

Aim: Routine therapeutic drug monitoring is highly recommended since common antidepressant combinations increase the risk of drug-drug interactions or overlapping toxicity. Materials & methods: A magnetic solid-phase extraction by using C18-functionalized magnetic silica nanoparticles (C18-Fe3O4@SiO2 NPs) as sorbent was proposed for rapid extraction of venlafaxine, paroxetine, fluoxetine, norfluoxetine and sertraline from clinical plasma and urine samples followed by ultra-HPLC-MS/MS assay. Results: The synthesized C18-Fe3O4@SiO2 NPs showed high magnetization and efficient extraction for the analytes. After cleanup by magnetic solid-phase extraction, no matrix effects were found in plasma and urine matrices. The analytes showed LODs among 0.15-0.75 ng ml-1, appropriate linearity (R ≥ 0.9990) from 2.5 to 1000 ng ml-1, acceptable accuracies 89.1-110.9% with precisions ≤11.0%. The protocol was successfully applied for the analysis of patients' plasma and urine samples. Conclusion: It shows high potential in routine therapeutic drug monitoring of clinical biological samples.

A Fatal Case Involving N-Ethyldeschloroketamine (2-Oxo-PCE) and Venlafaxine.

Methoxetamine, 3-methoxyphencyclidine or 3-methoxyeticyclidine are arylcyclohexylamines which have been abused in the past. However, the market for new psychoactive substances, in particular for research chemicals, is rapidly growing and new compounds are being regularly explored by users. Abuse can lead to clinical case and in the worst-case scenario to fatalities. We present the fatal case of a 52-year-old man, who was found dead in the bedroom by his fiancé. He had abused N-ethyldeschloroketamine and venlafaxine prior to his death. These compounds were retrieved from a non-targeted gas chromatography/mass spectrometry-based screening approach of a purified urine sample. In addition, deschloroketamine, bisoprolol and ramiprilate were found in the urine sample, but were either absent or only present at low level in femoral blood. During autopsy a number of tablets were found in the duodenum and identified as venlafaxine. Furthermore, N-ethyldeschloroketamine was quantified in various specimens taken during autopsy and the highest concentration was observed in liver (6,137 ng/g) followed by urine (3,468 µg/L), bile fluid (3,290 µg/L), gastric contents (3,086 µg/L), heart blood (2,159 µg/L) and liquor (1,564 µg/L). The smallest amount was found in femoral blood (375 µg/L). N-ethyldeschloroketamine was also found in the disposable syringes, in a beaker and on the spatula along with deschloroketamine, morphine, metamizole, oxycodone, flupirtin or ibuprofen. The concentrations presented-in particular for femoral blood-are a good starting point for evaluating N-ethyldeschloroketamine intoxications in the future. The other values are helpful for evaluating the post-mortem concentration distribution of this research chemical.

Ultrasonic assisted magnetic dispersive solid phase microextraction for pre concentration of serotonin-norepinephrine reuptake inhibitor drugs.

A simple and sensitive ultrasonic assisted magnetic dispersive solid phase microextraction method (UAMDSPME) coupled with high performance liquid chromatography was developed to determine serotonin-norepinephrine reuptake inhibitor drugs including duloxetine (DUL), venlafaxine (VEN) and atomoxetine (ATO) in human urine, river water and well water samples. A novel and efficient SPME sorbent, magnetic p-Phenylenediamine functionalized reduced graphene oxide Quantum Dots@ Ni nanocomposites (MrGOQDs-PD@ Ni), was prepared and applied for extraction of the analytes. Several effective parameters on the extraction efficiency of the analytes were investigated and optimized with experimental design approach. The performance of MrGOQDs-PD@ Ni as the SPME sorbent for the extraction of DUL, VEN and ATO was then compared with magnetic graphene oxide (MGO@Fe3O4) and magnetic reduced graphene oxide (MrGO@ Ni). Under the optimized conditions for the MrGOQDs-PD@ Ni sorbent, the intra-day relative standard deviations (RSDs, n = 5) and the limits of detections (LODs) were lower than 4.6% and 1.1 ngmL-1, respectively. Moreover, the good linear ranges were observed in wide concentration ranges with R-squared larger than 0.9878. Finally, the enrichment factors in the range of 137-183 and the recovery percentage in the range of 89.2-94.8% were obtained to determine the analytes in the real samples.

Glycine functionalized multiwall carbon nanotubes as a novel hollow fiber solid-phase microextraction sorbent for pre-concentration of venlafaxine and o-desmethylvenlafaxine in biological and water samples prior to determination by high-performance liquid chromatography.

A hollow fiber solid-phase microextraction method for pre-concentration of venlafaxine and o-desmethylvenlafaxine in biological matrices is described for the first time. The functionalized MWCNTs with an amino acid, glycine, were synthesized and held in the pore of a hollow fiber by sol-gel technique. In order to extract venlafaxine and o-desmethylvenlafaxine from real samples, the hollow fiber was immersed into the sample solution under a magnetic stirring for 20 min. The extracted venlafaxine and o-desmethylvenlafaxine from the fibers were then desorbed with methanol by sonication and analyzed using high-performance liquid chromatography. Important microextraction parameters including pH of donor phase, donor phase volume, stirring rate, extraction time, and desorption conditions such as the type and volume of solvents and desorption time were thoroughly investigated and optimized. The optimized technique provides good repeatability (RSD of the intraday precision 3.7 and 3.4, interday precision of 5.8 and 5.4 %), linearity of (0.1-300 and 0.2-360 ng mL(-1)), low LODs of (0.03 and 0.07 ng mL(-1)), and high enrichment factor of (164 and 176) for venlafaxine and o-desmethylvenlafaxine, respectively. The analytical performance of Gly-MWCNTs as a new SPME sorbent was compared with MWCNTs and carboxylic MWCNTs. The results indicate that Gly-MWCNTs are quite effective for extraction of venlafaxine and o-desmethylvenlafaxine. Feasibility of the method was evaluated by analyzing human urine and real water samples. The results obtained in this work show a promising, simple, selective, and sensitive sample preparation and determination method for biological and water samples.

NMR-based metabonomic analysis of normal rat urine and faeces in response to (±)-venlafaxine treatment.

(±)-Venlafaxine, a bicyclic antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class, is prescribed for the treatment of depression and anxiety disorders. As is the case with other antidepressants, its precise mechanisms of action are still unknown. Pharmacometabonomic approaches allow for the detection of diverse metabolites, unlike classic methods for analysing drug interaction based on single metabolites and linear pathways. This provides a global view of the state of homeostasis during treatment and an insight into the mechanisms of action of a drug. Accordingly, the final outcome of treatment is characterised by the network of reactome pathways derived from the on-target and off-target effects of the drug. Regarding antidepressants, the drug network may be located in the gut-microbiome-brain-liver-kidney-immune-cardiovascular system axis (GMBLKICA), implying that neurotransmitters participate as signalling molecules in bidirectional communication. If their bioavailability is increased, this communication and the state of homeostasis may be disrupted. With a pharmacometabonomic approach using NMR in combination with different chemometric methods, a determination was made of subtle changes in the metabolic profile (metabotype) of urine and faeces in normal Wistar rats following a single administration of pharmacological doses of (±)-venlafaxine hydrochloride. Based on the drug-response metabotypes observed, (±)-venlafaxine had effects on gut microbial co-metabolites and osmolytes. Hence, it can be hypothesized that bidirectional communication in the multiorgan axis was perturbed by this drug, and very likely by its active metabolite, (±)-desvenlafaxine. This disrupted signalling could be related not only to therapeutic and adverse effects, but also to the lag period in treatment response.