Parameter Set Neuroleptics 2/EXTENDED 2 - LC-MS/MS

Clinical relevance

Neuroleptics are a class of drugs with antipsychotic effects. They counteract hallucinations and delusions, and are primarily used in the treatment of schizophrenia. Their mechanism of action is attributed to their effects on synaptic impulse transmission in the central nervous system. When neuroleptics bind to specific receptors for neurotransmitters (notably dopamine), they prevent impulse transfer and thus inhibit signal transduction.

A key issue in treatment with antipsychotics is finding the right dose, a difficult and potentially time-consuming process because of significant interindividual differences. A lack of response may be pharmacokinetic or pharmacodynamic in origin. Inadequate patient compliance is another factor that may compromise response to treatment.

Studies have demonstrated for some psychoactive drugs that therapeutic drug monitoring improves the likelihood of response to treatment and may help to prevent side effects. This has a positive impact on patient compliance and also has cost-saving potential.

Blood level monitoring is indicated in psychiatry if for instance a medicine is being taken for the first time or dosage adjustment is necessary; if it is suspected that the patient is not taking the drug properly or at all; if adverse reactions occur; if the patient is not responding to treatment; if drug interactions are likely, or if special populations are involved (under 18 or over 65 years of age, patients with learning difficulties, special metabolic circumstances).

In addition to a number of important neuroleptics, this kit can also be used to determine guanfacine, a centrally active alpha-2 receptor agonist. Guanfacine is used in the treatment of attention deficit hyperactivity disorder (ADHD) in patients who are unable to use central stimulants. Since overdosing can cause serious poisoning, patient monitoring is crucial.

Product advantages

• 28 analytes in a single run
• Internal standards for nearly all analytes
• Part of the continuously updated MassTox® TDM Series A

To avoid interferences and enable a clear analysis, the neuroleptics were divided into two Parameter Sets, Neuroleptics 1/EXTENDED and Neuroleptics 2/EXTENDED 2. The present analysis set Neuroleptics 2/EXTENDED 2 has been further extended by the 15 parameters: Benperidol, Brexpiprazole, Bromperidol, Cariprazine, Chlorpromazine, Flupentixol, Fluphenazine, Guanfacine, Iloperidone, Loxapine, Lurasidone, Perphenazine, Pimozide, Prothipendyl, Sulforidazine.

With the Parameter Set Neuroleptics 2/EXTENDED 2 in serum/plasma, 28 neuroleptic drugs and guanfacine can be measured fast and efficiently using LC-MS/MS. Due to the careful optimisation of all kit components as well as the chromatographic separation, matrix effects (“ion suppression”) are minimised and the robustness of the method is enhanced. Sample preparation is based on a protein precipitation step. The use of stable isotopically labelled (deuterated) and co-eluting internal standards as well as 3PLUS1® multilevel calibrators ensures high precision and reproducible and reliable quantification of the analytes. The method is comprehensively validated.

The Parameter Set is a part of the Series A modular system, which enables the analysis of all parameters without switching column or changing the mobile phases, thereby minimising required workload in the laboratory. The Basic Kit A contains all components required for sample preparation and all necessary mobile phases. The MasterColumn® A is the analytical column used for the determination of all Series A analytes. Our portfolio contains further MassTox® Parameter Sets.

For the analysis you require the MassTox® TDM Basic Kit A, the specific MassTox® TDM Parameter Set and the analytical column MassTox® TDM MasterColumn® A.