- Integrated DBS with modified capillary-in-capillary electrospray ionisation coupled to a miniature mass spectrometer enables rapid, on-site therapeutic drug monitoring of psychotropic agents.
- Disposable polypropylene sampling capillary houses a DBS punch and solvent for online extraction, ionisation and mass analysis, reducing sample preparation from hours to minutes.
- Method shows excellent linearity R2 > 0.95, precision, and comparable performance to solid phase extraction for six psychotropic drugs; clinical detection confirmed.
J Am Soc Mass Spectrom. 2026 Jun 3. doi: 10.1021/jasms.6c00148. Online ahead of print.
ABSTRACT
Therapeutic drug monitoring (TDM) of psychotropic agents is essential for optimizing therapeutic efficacy and minimizing adverse effects. However, conventional liquid chromatography-tandem mass spectrometry (LC-MS/MS) workflows are poorly suited for point-of-care applications due to labor-intensive sample preparation, prolonged turnaround times, and dependence on centralized analytical laboratories. Here, we present a rapid, on-site analytical platform that integrates dried blood spot (DBS) sampling with a modified capillary-in-capillary electrospray ionization (CC-ESI) source coupled to a miniature mass spectrometer (mini-MS). The sampling capillary was re-engineered as a disposable polypropylene microtube capable of accommodating a DBS punch and extraction solvent, thereby enabling fully integrated online extraction, ionization, and mass analysis within minutes. Critical parameters, including infrared drying duration and extraction solvent composition, were systematically optimized. The method demonstrated excellent linearity (R2 > 0.95) and precision for six widely prescribed psychotropic drugs: diazepam, flurazepam, clozapine, zolpidem, risperidone, and methaqualone. Analytical performance was comparable to that achieved using conventional solid-phase extraction, yet sample preparation time was reduced from several hours to mere minutes. Clinical utility was preliminarily demonstrated by the successful detection and confirmation of clozapine and aripiprazole in blood samples from patients receiving long-term pharmacotherapy. This DBS-CC-ESI-mini-MS platform represents a promising advance toward decentralized TDM of psychotropic drugs, offering minimal invasiveness, operational simplicity, and rapid, reliable quantitative capability.
PMID:42233231 | DOI:10.1021/jasms.6c00148
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