Identification of some drug metabolites is typically done using blood samples, however urine analysis is also a viable way to determine metabolites from a given drug. Reports indicate that there is poor compliance with antipsychotic drug prescriptions, and three antipsychotic drugs, Seroquel®, Latuda® and Haldol®, were analyzed for alternative metabolites that could be monitored for improved patient positivity. Both known and unknown metabolites were identified using LC-QTOF in combination with hydrolysis. Seroquel® (Quetiapine) usage is currently tested by monitoring N-desalkyl quetiapine or 7-hydroxy quetiapine, only 12% of the radioactive dose. This study shows that the carboxylic acid and sulfoxide metabolites are vital in establishing patient positivity. Smaller fragments of lurasidone are reported to be the most prevalent metabolites in Latuda® (Lurasidone). This study revealed that lurasidone and hydroxylurasidone, along with the unconfirmed metabolites M-21 and M-22, are actually the most abundant metabolites of Latuda® in urine. Haldol® (Haloperidol) was reported as not being conjugated during metabolism, with reduced haloperidol and two small acid fragments as the main metabolites. However, this study discovered that haloperidol is substantially glucuronidated and hydrolysis significantly improves detection.
Independent technical poster presented by Erin C. Strickland – Amertiox, Ltd. at MSACL 2016