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October 29, 2014
The Testing of Patients Using Psychotropic Drugs

Approximately eleven percent, or almost 35 million Americans over the age of 12 are using an antidepressant medication and this number is even higher in some subpopulations. While the mechanism of action is not known for all psychotropic medications, many of the most popular drugs work by inhibiting the reuptake of various neurotransmitters in the synapse. There are still many questions about what effect these medications have on urinary neurotransmitter levels. Some evidence indicates that neurotransmitter levels in circulation and excreted in urine may increase with reuptake inhibition, while others find levels depleted with reported use of these medications. The difference may be due to the length of time a patient uses the drug, or to individual physiology. One study found that after only 24 hours there was an 89% increase in serotonin excretion with paroxetine (Paxil) usage. Other evidence indicates that reuptake inhibition creates a deficiency in the neurotransmitter level over time. Rat studies indicate that serotonin levels were depleted by an average of 60% on citalopram (Celexa).

Because these medications are so widely used, and because of their potential impact on neurotransmitter levels, we are often asked about whether patients should discontinue their medications for testing. We do not require that the patient discontinue the medication for any length of time prior to testing for two primary reasons. First, because many patients are reliant on these medications and stopping them should be done with close medical supervision. Second, there is value in testing the patient "where they are at". In other words, if they have been taking the medication, but are still feeling less than optimal, we recommend you test them and go from there. Many of our practitioners use NT testing, and subsequent targeted amino acid support, when they are taking a patient off of one of these medications, while others may use the testing and recommended support to augment or complement the existing therapy.

When testing patients taking psychotropic medications, advise them to continue to take these medications on the day of testing. There is no need to take a break before collecting the urine sample.


  • Pratt, LA, Brody DJ and Gu Q. Antidepressant use in persons aged 12 and over: United States, 2005-2008. NCHS Data Brief. No. 76, Oct 2011
  • http://www.gallup.com/poll/145868/chronic-health-conditions-prevalent-2010-2009.aspx
  • Kotzailias N, Marker M, Jilma B. Early effects of paroxetine on serotonin storage, plasma levels, and urinary excretion: a randomized, double-blind, placebo-controlled trial. J Clin Psychopharmacol. 2004 Oct;24(5):536-9.
  • Bosker FJ, Ranke MAC, Jongsma ME et al. Biochemical and behavioral effects of long-term citalopram administration and discontinuation in rats: Role of serotonin synthesis. Neurochem Int. 2010 Dec, 57(8):948-57.
  • Gonzales GF, Carillo C. Blood serotonin levels in postmenopausal women: effects of age and serum oestradiol levels. Maturitas. 1993;17:23-9.
  • Kaura V, et al. The progesterone metabolite allopregnanolone potentiates GABAa receptor-mediated inhibition of 5-ht neuronal activity. Eur Neuropsychopharm. 2007; 17: 108-15.

Labrix Advanced Workshop

Click here for a special invitation to Labrix Advanced Workshop from Labrix co-founder and CEO Dr. Erin Lommen.

Click here to register today!

Labrix Celebrates its 10th Anniversary!

Labrix co-founders Dr. Erin Lommen and Dr. Jay Mead sit down for a short interview and discuss the company's first ten years, as well as its bright future with diagnostic testing.

Advanced Workshop
Las Vegas, NV
Jan 24-25, 2015

Registration is just $199 for Labrix Advanced Workshop (LAW). Register for LAW today.

Core Training
Atlanta, GA
March 14, 2015

Registration is $150 and upon clompleting this one day training, you will receive a $100 credit on your testing account. Register for Atlanta Core Training today.

Atlanta, GA
Nov 6-9, 2014

Labrix' co-founders Dr. Erin Lommen and Dr. Jay Mead will be speaking at AFMA.

To receive $100 off your registration, use code EL2 or JM2 when registering for the conference.

Las Vegas, NV
Dec. 11-13, 2014

Labrix' co-founder Dr. Lommen will be speaking at A4M.

Dr. Erin Lommen will be speaking on Metabolic Syndrome and Menopause.