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

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.