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Pain Management Antidepressants, With Confirmation, Urine

Test code(s) 94032, 70204, 16903

Question 1. What are antidepressants?

Antidepressants are medications that can be used to treat mild, moderate, and severe major depression. These medications may also be used to treat anxiety and eating disorders as well as pain (fibromyalgia and neuropathic).

The pharmacologic actions of antidepressants are based upon the monoamine hypothesis: antidepressant effects result from inhibition of monoamine oxidase breakdown of monoamine neurotransmitters.

Examples of antidepressant drug classes include:

  • Selective serotonin reuptake inhibitors (SSRI)
  • Serotonin-norepinephrine reuptake inhibitors (SNRI)
  • Serotonin modulators and stimulators (SMS)
  • Serotonin antagonists and reuptake inhibitors (SARI)
  • Norepinephrine reuptake inhibitors (NRI)
  • Norepinephrine-dopamine reuptake inhibitors (NDRI)
  • Tricyclic antidepressants (TCA)
  • Tetracyclic antidepressants (TeCA)
  • Monoamine oxidase inhibitors (MAOI)

Question 2. Why test for antidepressants?

Drug testing in the clinical setting can provide information that can improve patient care. The results of drug testing can often prompt important clinical discussions with patients. For example, absence of an expected drug could suggest poor adherence or diversion, whereas detection of a nonprescribed or illicit drug could raise concerns regarding substance misuse. Discrepancies between expected and actual results could also call attention to patient intolerance to medication side effect or potential medical factors affecting drug disposition.

Question 3. What are the test codes for the pain management antidepressant tests?

The test codes are:

Question 4. Where will the tests be performed?

Test code 94032 will be performed at Quest Diagnostics Nichols Institute, Chantilly. Additional labs will be added at a later date.

Test codes 70204 and 16903 are performed at multiple Quest laboratories.

Question 5. What are the characteristics of the pain management antidepressant tests?

Test Code 94032
Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is used for both the presumptive analysis and the definitive quantitative confirmation.

Multiple antidepressant drugs from various classes are included in the tests. A list of them and the associated cutoffs can be found here.

Test codes 70204 and 16903
Mass spectrometry is used for quantitation of amitriptyline and nortriptyline.

Question 6. What does the test result mean?

Negative results indicate absence of drug and/or metabolite or concentrations below the assay cutoff. Positive results indicate presence of the respective drug and/or metabolite.

Question 7. Can specimens for antidepressant testing be sent in the same bag with other clinical specimens?

Yes. Urine antidepressant testing is considered a clinical test; therefore, the specimens may be placed in the same specimen bag (one patient per bag) with other clinical specimens.

Question 8. Whom should a client call with questions about this test?

If you have any questions regarding this information or require assistance with interpreting these drug test results, please contact a Quest Diagnostics toxicology specialist at 1.877.40.RXTOX (1.877.407.9869). Specialists are available to assist you Monday through Friday from 8 AM to 6 PM EST.

This FAQ is provided for informational purposes only and is not intended as medical advice. A clinician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.
Document FAQS.188 Version: 0
Effective 03/26/2018 to present