Case Report
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Year 2023, Volume: 45 Issue: 4, 96 - 99, 31.12.2023
https://doi.org/10.7197/cmj.1371692

Abstract

References

  • 1. Kalant H. (2001). The pharmacology and toxicology of "ecstasy" (MDMA) and related drugs. CMAJ. 165: 917-28.
  • 2. World Drug Report 2020 (United Nations publication, Sales No. E.20.XI.6). (2020). Drug Use and Health Consequences. United Nations Office on Drugs and Crime. Available from:https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf (accessed February 22, 2021).
  • 3. EMIT Drugs-of-Abuse Urine Assays Cross-Reactivity List. (2011). Siemens Healthcare Diagnostics Inc.
  • 4. Nixon AL, Long WH, Puopolo PR, Flood JG. (1995). Bupropion metabolites produce false-positive urine amphetamine results. Clin Chem. 41: 955-6.
  • 5. Weintraub D, Linder MW. (2000). Amphetamine positive toxicology screen secondary to bupropion. Depress Anxiety. 12: 53-4.
  • 6. Vidal C, Skripuletz T. (2007). Bupropion interference with immunoassays for amphetamines and LSD. Ther Drug Monit. 29: 373-5.
  • 7. Reidy L, Walls HC, Steele BW. (2011). Cross reactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 33: 366-8.
  • 8. Öztürk SS, Özayhan HY, Demiröz D, Yaşar SA, Tanrıkulu AB, Eren İ. (2019). False positive toxicologic screening of amphetamine and ecstasy (MDMA) following bupropion use. Psychiatry Clin Psychopharmacol. S1, 29: 221-2.
  • 9. Casey ER, Scott MG, Tang S, Mullins ME. (2011). Frequency of false positive amphetamine screens due to bupropion using the Syva Emit II Immunoassay. J Med Toxicol. 7: 105-8.
  • 10. Marin SJ, Doyle K, Chang A, Concheiro-Guisan M, Huestis MA, Johnson-Davis KL. (2016). One Hundred False-Positive Amphetamine Specimens Characterized by Liquid Chromatography Time-of-Flight Mass Spectrometry. J Anal Toxicol. 40: 37-42.
  • 11. Johnson-Davis KL, Sadler AJ, Genzen JR. (2016). A Retrospective Analysis of Urine Drugs of Abuse Immunoassay True Positive Rates at a National Reference Laboratory. J Anal Toxicol. 40: 97-107. 12. SIEMENS Dimension® Flex® reagent cartridge EXTC

False positive ecstasy (MDMA) urine drug screening test results due to bupropion use: A case report

Year 2023, Volume: 45 Issue: 4, 96 - 99, 31.12.2023
https://doi.org/10.7197/cmj.1371692

Abstract

This case report is about a false positive ecstasy (MDMA) result in the urine substance abuse screening analysis of a person using the antidepressant drugs bupropion and sertraline with a therapeutic indication. Urine drug and stimulant screening analysis of a 25-year-old male patient who is history of bupropion (300 mg/day) and sertraline (100 mg/day) use, followed in the Amatem polyclinic due to the probation law, was performed with Syva® Emit® II Plus kits and immunoassay method. In order to confirm the ecstasy test, which was positive in the screening analysis, the substance analysis was repeated on the same sample with the gas chromatography sequential mass spectrometry (GC-MS) method and ecstasy was not detected in the confirmation analysis. At the same time, the presence of bupropion and sertraline patient declared to use, was confirmed with the LC-MS-Iontrap device. In conclusion, with this case example, we wanted to highlight the potential interaction of bupropion with the Syva® Emit® II Plus urine ecstasy screening tests, which could lead to false positive results. When positive ecstasy values are detected in the urine samples analyzed with the immunoassay method in patients using bupropion, the final decision should be made after a confirmatory analysis.

Thanks

We would like to extend our sincere thanks to Toksilab and MVZ Labor Dessau GmbH undertaking the analyses.

References

  • 1. Kalant H. (2001). The pharmacology and toxicology of "ecstasy" (MDMA) and related drugs. CMAJ. 165: 917-28.
  • 2. World Drug Report 2020 (United Nations publication, Sales No. E.20.XI.6). (2020). Drug Use and Health Consequences. United Nations Office on Drugs and Crime. Available from:https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf (accessed February 22, 2021).
  • 3. EMIT Drugs-of-Abuse Urine Assays Cross-Reactivity List. (2011). Siemens Healthcare Diagnostics Inc.
  • 4. Nixon AL, Long WH, Puopolo PR, Flood JG. (1995). Bupropion metabolites produce false-positive urine amphetamine results. Clin Chem. 41: 955-6.
  • 5. Weintraub D, Linder MW. (2000). Amphetamine positive toxicology screen secondary to bupropion. Depress Anxiety. 12: 53-4.
  • 6. Vidal C, Skripuletz T. (2007). Bupropion interference with immunoassays for amphetamines and LSD. Ther Drug Monit. 29: 373-5.
  • 7. Reidy L, Walls HC, Steele BW. (2011). Cross reactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 33: 366-8.
  • 8. Öztürk SS, Özayhan HY, Demiröz D, Yaşar SA, Tanrıkulu AB, Eren İ. (2019). False positive toxicologic screening of amphetamine and ecstasy (MDMA) following bupropion use. Psychiatry Clin Psychopharmacol. S1, 29: 221-2.
  • 9. Casey ER, Scott MG, Tang S, Mullins ME. (2011). Frequency of false positive amphetamine screens due to bupropion using the Syva Emit II Immunoassay. J Med Toxicol. 7: 105-8.
  • 10. Marin SJ, Doyle K, Chang A, Concheiro-Guisan M, Huestis MA, Johnson-Davis KL. (2016). One Hundred False-Positive Amphetamine Specimens Characterized by Liquid Chromatography Time-of-Flight Mass Spectrometry. J Anal Toxicol. 40: 37-42.
  • 11. Johnson-Davis KL, Sadler AJ, Genzen JR. (2016). A Retrospective Analysis of Urine Drugs of Abuse Immunoassay True Positive Rates at a National Reference Laboratory. J Anal Toxicol. 40: 97-107. 12. SIEMENS Dimension® Flex® reagent cartridge EXTC
There are 11 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Case Reports
Authors

Selin Acar Şahan 0000-0003-4083-8660

Barış Karadaş 0000-0001-9347-2565

Semra Aydın Akfırat 0000-0002-3112-0852

Nihat Aydemir 0009-0004-6334-0931

Saliha Aksun 0000-0002-7991-1645

Yusuf Kaplan 0000-0003-0369-7934

Publication Date December 31, 2023
Acceptance Date December 12, 2023
Published in Issue Year 2023Volume: 45 Issue: 4

Cite

AMA Acar Şahan S, Karadaş B, Aydın Akfırat S, Aydemir N, Aksun S, Kaplan Y. False positive ecstasy (MDMA) urine drug screening test results due to bupropion use: A case report. CMJ. December 2023;45(4):96-99. doi:10.7197/cmj.1371692