Comprehensive Monitoring of Psychoactive Substances in Psychiatric Patients Using Liquid Chromatography-High-Resolution Mass Spectrometry: A Key Tool for Treatment Planning and Understanding Consumption Patterns in Rome, Italy.
Journal
Therapeutic drug monitoring
ISSN: 1536-3694
Titre abrégé: Ther Drug Monit
Pays: United States
ID NLM: 7909660
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
21
06
2023
accepted:
05
10
2023
medline:
18
3
2024
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
ppublish
Résumé
The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes. Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use. Comprehensive drug screening was conducted for all samples using ultra-high-performance liquid chromatography-high-resolution mass spectrometry. A total of 71 blood and urine and 50 hair samples were analyzed to confirm the suitability of the ultra-high-performance liquid chromatography-high-resolution mass spectrometry method for the study purposes. The main substances found in blood and urine were antipsychotics (71.8% and 66.2%) and benzodiazepines (62.0% and 59.2%), respectively, whereas cocaine (84.0%) and antipsychotics (74.0%) was more evident in hair. Z-drugs were detected in blood (7.0%), urine (5.6%), and hair (24%) samples; amphetamines were mainly detected in hair samples (14.0%). Synthetic cathinones were the most frequently detected NPS in hair specimens (8.0%), whereas synthetic cannabinoids were mainly found in blood samples (11.3%). These analyses showed that patients were polydrug users (77.5% detected in blood and urine, and 94.0% in hair). Comprehensive screening enabled the assessment of past, recent, and actual consumption of psychoactive substances, including licit and illicit drugs and NPS, by psychiatric patients. A thorough understanding of substance consumption patterns can enhance therapeutic interventions and management of psychiatric disorders associated with psychoactive substance use.
Sections du résumé
BACKGROUND
BACKGROUND
The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes.
METHODS
METHODS
Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use. Comprehensive drug screening was conducted for all samples using ultra-high-performance liquid chromatography-high-resolution mass spectrometry.
RESULTS
RESULTS
A total of 71 blood and urine and 50 hair samples were analyzed to confirm the suitability of the ultra-high-performance liquid chromatography-high-resolution mass spectrometry method for the study purposes. The main substances found in blood and urine were antipsychotics (71.8% and 66.2%) and benzodiazepines (62.0% and 59.2%), respectively, whereas cocaine (84.0%) and antipsychotics (74.0%) was more evident in hair. Z-drugs were detected in blood (7.0%), urine (5.6%), and hair (24%) samples; amphetamines were mainly detected in hair samples (14.0%). Synthetic cathinones were the most frequently detected NPS in hair specimens (8.0%), whereas synthetic cannabinoids were mainly found in blood samples (11.3%). These analyses showed that patients were polydrug users (77.5% detected in blood and urine, and 94.0% in hair).
CONCLUSIONS
CONCLUSIONS
Comprehensive screening enabled the assessment of past, recent, and actual consumption of psychoactive substances, including licit and illicit drugs and NPS, by psychiatric patients. A thorough understanding of substance consumption patterns can enhance therapeutic interventions and management of psychiatric disorders associated with psychoactive substance use.
Identifiants
pubmed: 38018870
doi: 10.1097/FTD.0000000000001163
pii: 00007691-990000000-00170
doi:
Substances chimiques
Illicit Drugs
0
Psychotropic Drugs
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
203-209Subventions
Organisme : Italian Academy for Advanced Studies in America, Columbia University
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
Références
Saitman A, Park HD, Fitzgerald RL. False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol. 2014;38:387–396.
Stephenson JB, Flater ML, Austin J, et al. Comprehensive drug screening of whole blood by LC–HRMS–MS in a forensic laboratory. J Anal Toxicol. 2021;45:243–251.
Marchei E, Ferri MA, Torrens M, et al. Ultra-high performance liquid chromatography-high resolution mass spectrometry and high-sensitivity gas chromatography-mass spectrometry screening of classic drugs and new psychoactive substances and metabolites in urine of consumers. Int J Mol Sci. 2021;22:4000.
Marchei E, Rotolo MC, Mannocchi G, et al. Assessment of licit and illicit drugs consumption during pregnancy by ultra-high performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) target screening in Mexican women hair. J Pharm Biomed Anal. 2022;211:114607.
Wille SMR, Desharnais B, Pichini S, et al. Liquid chromatography high-resolution mass spectrometry in forensic toxicology: what are the specifics of method development, validation and quality assurance for comprehensive screening approaches? Curr Pharm Des. 2022;28:1230–1244.
Matuszewski BK, Constanzer ML, Chavez-Eng CM. Strategies for the assessment of matrix effect in quantitative bioanalytical methods based on HPLC–MS/MS. Anal Chem. 2003;75:3019–3030.
European Monitoring Centre for Drugs and Drug Addiction. Polydrug Use. European Monitoring Centre for Drugs and Drug Addiction; 2021. Available at: https://data.europa.eu/doi/10.2810/756632 . Accessed June 12, 2023.
Kintz P, Sengler C, Cirimele V, et al. Evidence of crack use by anhydroecgonine methylester identification. Hum Exp Toxicol. 1997;16:123–127.
World Drug Report; 2018. Available at: https://www.unodc.org/wdr2018/ . Accessed June 12, 2023.
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2022: Trends and Developments. Publications Office; 2022. Available at: https://data.europa.eu/doi/10.2810/75644 . Accessed June 12, 2023.
Tardelli VS, Fidalgo TM, Martins SS. How do medical and non-medical use of z-drugs relate to psychological distress and the use of other depressant drugs? Addict Behav. 2021;112:106606.
Roy S, Charreteur R, Peries M, et al. Abuse and misuse of second‐generation antipsychotics: an analysis using VigiBase, the World Health Organisation pharmacovigilance database. Br J Clin Pharmacol. 2022;88:4646–4653.
European Monitoring Centre for Drugs and Drug Addiction. Spotlight on… Non-Medical Use of Benzodiazepines. Available at: https://www.emcdda.europa.eu/spotlights/non-medical-use-benzodiazepines_en . Accessed June 12, 2023.
Acciavatti T, Lupi M, Santacroce R, et al. Novel psychoactive substance consumption is more represented in bipolar disorder than in psychotic disorders: a multicenter-observational study. Hum Psychopharmacol. 2017;32:e2578.
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2023: Trends and Developments. Available at: https://www.emcdda.europa.eu/publications/european-drug-report/2023_en . Accessed June 21, 2023.