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1Uniformed solutions University the the health and wellness Sciences, 4301 Jones bridge Road, Bethesda, MD 20814, USA
2Department of internal Medicine, Tripler military Medical Center, 1 Jarrett White Road, Honolulu, hello 96859-5000, USA
3Department of Psychiatry, Tripler military Medical Center, 1 Jarrett White Road, Honolulu, hi 96859-5000, USA
4Department that Pharmacy, Tripler military Medical Center, 1 Jarrett White Road, Honolulu, hello 96859-5000, USA
The target of this file is come report the first case the atomoxetine causing false-positive urine drug screen. One otherwise healthy and balanced 27-year-old female v a background of fist deficit hyperactivity disorder (ADHD) treated with atomoxetine had actually an acute beginning tonic-clonic seizure. On arrival to the hospital, a to pee toxicological drug screen with immunochemical copy enzyme donor immunoassay (CEDIA) was performed. Outcomes were optimistic for amphetamines; however, the presence of this substances might not be confirmed with pee gas chromatography-mass spectrometry (GC-MS). She denied any illicit drug use, organic medications, or supplements, and her various other prescription medications have actually not to be previously recognized to reason a false-positive result for amphetamines. When stimulant treatments for ADHD might certainly an outcome in a positive an outcome on urine display screen for amphetamines, there have actually been no reports the false-positive results for amphetamines second to patients making use of atomoxetine. We implicate atomoxetine, and/or its metabolites, as a link or link which might interfere with urine drug immunoassays bring about false-positive results for amphetamines CEDIA assays.1. Introduction
Atomoxetine is classified as a selective norepinephrine reuptake inhibitor and also is commonly prescribed together a nonstimulant treatment for the management of ADHD in children and also adults. The drug acts in ~ presynaptic norepinephrine transporters in neurons blocking removed of norepinephrine indigenous the synaptic cleft through a device that is not fully understood <1>. The major oxidative metabolite of atomoxetine is 4-hydroxyatomoxetine (active metabolite but present in a much lower concentration contrasted to the parent drug) i m sorry is ultimately conjugated to 4-hydroxyatomoxetine--glucoronide via the cytochrome P450 CYP2D6 pathway <1–3>. To a lesser extent, atomoxetine is demethylated to -desmethylatomoxetine, i beg your pardon is dramatically less active compared come the parental drug.
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Structurally, atomoxetine <-methyl-3-(2-methylphenoxy)-3-phenylpropan-1-amine> bears some similarities come amphetamine <1-phenylpropan-2-amine> (Figure 1) <1, 3>. Recent research also suggests the atomoxetine block -methyl--aspartate (NMDA) receptors altering glutaminergic transmission, and this system may contribute to that is efficacy together a therapy for ADHD <4>.