Drug testing involves analyzing plasma (serum) or urine to detect the presence or absence of a drug or its metabolites. As the metabolization rate of drugs including antidepressants differs, the window of detection for certain drugs or metabolites also varies. Antidepressants are not as addictive as substances like alcohol and heroin. Antidepressants abusers do not experience the cravings that other drugs cause, nor do they share the euphoria, addictive behaviors, or adverse effects that many other drugs do.
Antidepressants can also cause physical dependence in some people. People who suffer from depression are also more likely to misuse other substances. Antidepressant addiction can develop in people who never needed the drugs, to begin with. Some people are misdiagnosed with depression and given antidepressants as a result. According to one study, nearly two-thirds of patients with depression were misdiagnosed and given unnecessary antidepressants.
The World Health Organization (WHO) estimates that depression is the leading cause of disability worldwide, affecting 350 million people of all ages around the globe. The National Institute of Mental Health (NIMH) estimates that by the time they turn 18, 3.3 percent of adolescents will have a depressive disorder, and girls are more at risk than boys. Depression is characterized by episodes of sadness that affect everyday life and functioning. Symptoms must be present for at least two weeks to be diagnosed as a depressive disorder.
Anxiety disorders affect nearly 18 percent of the American population, around 40 million people. They are the most common mental illness in the country, as reported by the Anxiety and Depression Society of America (ADSA). These disorders include generalized anxiety disorder (GAD), panic disorders, post-traumatic stress disorder (PTSD), phobias, social anxiety disorder, and obsessive-compulsive disorder. Anxiety disorders affect the way stress is processed.
Antidepressants are commonly used in substance abusers due to the potential effect on some underlying mechanisms involved in drug use disorders and to treat comorbid depression.
Antidepressants are not considered drugs of abuse. That’s why employers generally don’t usually test for these prescriptions drugs in a screening. However, there may be cross-reactions that can produce false positive results for the substances these tests are designed to detect.
What does TCA mean on a drug test?
Terminologies in drug testing reports can sometimes point you in the wrong direction except you know exactly what they mean and why they are being screened for. TCA on drug testing reports and kits stands for Tricyclic antidepressants, blood or urine samples are often analyzed in order to determine whether a person is using or abusing tricyclic antidepressants (TCAs). The TCA Rapid Test is an immunochromatography-based one-step in vitro test. It is designed for qualitative determination of Nortriptyline in human urine specimens above a cut-off level of 1000 ng/mL, the test will be positive if the sample tested contains at least 1 000 nanograms of one of the medications in this class of pharmacopeia per milliliter of urine, or negative if the sample contains less or not at all.
According to Mayo Clinic, Tricyclic and tetracyclic antidepressants, also called cyclic antidepressants, are among the earliest antidepressants developed. They’re effective, but they’ve generally been replaced by antidepressants that cause fewer side effects. However, cyclic antidepressants may be a good option for some people. In certain cases, they relieve depression when other treatments have failed.
Cyclic antidepressants are designated as tricyclic or tetracyclic, depending on the number of rings in their chemical structure — three (tri) or four (tetra).
Hepatic metabolism is the primary mechanism of elimination of TCAs, with little to no excretion of either parent compound or active metabolite through the urine. SEE: What Does MTD Mean On A Drug Test
Tricyclic antidepressants test
| compounds | cut-off (ng/ml) |
| Nortriptyline | 1 000 |
| Amitriptyline | 1 000 |
| Chlorpromazine | 3 500 |
| Clomipramine | 10 000 |
| Cyclobenzaprine | 1 500 |
| Desipramine | 500 |
| Diphenhydramine | 20 000 |
| Doxepine | 1 000 |
| Imipramine | 800 |
| Nordoxepine | 1 000 |
| Opipramol | 4 000 |
| Protriptyline | 3 000 |
| Perphenazine | 25 000 |
| Promazine | 200 |
| Promethazine | 40 000 |
| Trimipramine | 2 500 |
Several TCA metabolites are active and prolongation of TCA half-lives may occur as a result of saturation of metabolic pathways or when hepatic metabolic pathways are deficient (e.g., very young, very old, preexisting hepatic disease). SEE: Is Trazodone An Addictive Drug?
