Quetiapine Shows Cross-reactivity in Urine Drug Screening for Ketamine

Quetiapine造成愷他命尿液篩檢偽陽性

李彥鋒(Yen-Feng Lee)；梁志頌(Chih-Sung Liang)；曾裕庭(Yu-Ting Tseng)；彭嘉和(Chia-Ho Peng)

cross-reactivity ； urine drug screening ； ketamine ； quetiapine ； 交互作用 ； 尿液藥物濫用篩檢 ； 愷他命 ； quetiapine

台灣精神醫學

32卷4期（2018 / 12 / 01）

323 - 330+iii

英文

Background: Ketamine use disorder has become a major public-health problem. Urine drug screening for ketamine is essential in prevention programs at both individual and community levels. But no data exist for compounds in urine that may interfere with drug tests and cause false-positive results. We suspect that quetiapine may show cross-reactivity in urine drug screening for ketamine. Methods: We recruited 573 patients and divided them into a quetiapine-treated group (QTG) and a quetiapine-untreated group (QUG). Then, we determined the association between the dosage of quetiapine and that of false-positive results. Results: We collected 51 patients in the QTG, and 522 patients in the QUG. In the QTG, 44.2% of patients showed false positive. In the QUG, the ratio of false-positive results was 0.8%. The dose of quetiapine was found to be significantly associated with false-positive results (p ＜ 0.05, odds ratio = 1.415, 95% confidence interval = 1.013-1.977). But the factors of patients’ sex, age, body weight, height of did not show any significant difference between two groups. Conclusion: Quetiapine is a widely used second-generation (atypical) antipsychotic drug. To avoid mis-inter-pretating the data and misleading clinical decisions, physicians should be aware of its potential of cross-reaction of ketamine and quetiapine in urine drug screening tests. Double-check for the ketamine use is required to confirm the ketamine use in quetiapine-medicated patients with ketamine use disorder.

背景：愷他命濫用是個嚴重的社會議題，而尿液篩檢是我們在進行毒品防制中很常用的工具。然而，在臨床的運用中，我們發現quetiapine可能會影響篩檢盤的結果。研究方式：我們研究了573個接受尿液篩檢的病人，將病人分成有服用quetiapine (QTG)組，和沒有服用quetiapine (QUG)組。分析兩組病人尿液篩檢偽陽性發生之機率，進行分析。結果：QTG有51名個案，QUG有522名個案。QTG的偽陽性44.2%，而QUG有0.8%。在QTG組中，quetiapine的劑量與偽陽性呈現顯著相關（p ＜ 0.05，風險指數 = 1.415, 95%信賴程度 =1.013-1.977）。病人的年齡、性別、身高、體重等則沒有影響此結果。結論：Quetiapine是個常用的抗精神病藥物，而偽陽性可能會誤導我們臨床的判斷。因此，在服用quetiapine出現愷他命篩檢盤陽性反應時，建議要再以其他檢驗方式再行確認。

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