Quantification of nine psychotropic drugs in postmortem dried blood spot samples by liquid chromatography-tandem mass spectrometry for simple toxicological analysis

Dried blood spot (DBS) sampling has evolved to become the method of choice for collecting samples for newborn screening and therapeutic drug monitoring worldwide. The major advantage of this approach is that it requires only a small amount of blood. In addition, the collection of DBSs on filter paper is simple, sample storage costs are small, and the process deactivates microorganisms and viruses. However, despite these advantages, DBS sampling is seldom used in forensic toxicological analyses. Here, we developed and validated an approach that uses liquid chromatography coupled with electrospray ionization-tandem mass spectrometry for quantifying nine psychotropic drugs (citalopram, duloxetine, mirtazapine, olanzapine, paroxetine, quetiapine, sertraline, zolpidem and zopiclone) in cadaveric DBS samples. Most of them are frequently used by self-harm but are not already targeted by an existing drug screening kit. Our method use only one 3-mm disk excised from each DBS and does not require the troublesome purification process. The linearities of the calibration curves were good in the concentration range of 0.05-1.0 mu g/mL. Our method allows for repeatable and accurate quantification with intra- and inter-assay coefficients of variation of below 11.9% and below 12.5%, respectively, for each of the target drugs. In addition, the target drug concentrations in the DBSs remained stable for at least one month when stored at - 80 degrees C. Compared with our institute's routine method for cadaveric blood sampling, the QuEChERS method, quantifiable concentrations showed a good positive correlation for each of the target drugs. In addition, the concentrations of almost all the target drugs obtained with DBS sampling method were comparable with those obtained with the QuEChERS sampling method. Thus, the present findings extend the possible uses of DBS sampling to the quantification of multiple psychotropic drugs in the field of forensic toxicological testing.

Automated summary

Dried blood spot (DBS) sampling has become the preferred method for newborn screening and therapeutic drug monitoring worldwide. It requires only a small amount of blood and has advantages such as simple collection, low sample storage costs, and microbial deactivation. However, DBS sampling is rarely used in forensic toxicological analyses.