J Am Pharm Assoc (2003). 2022 Sep-Oct;62(5):1707-1710. doi: 10.1016/j.japh.2022.05.011. Epub 2022 May 17.
The objective of this case report is to highlight the possibility of the second-generation antipsychotic ziprasidone causing a false positive result for fentanyl on a urine drug screen (UDS).
A 70-year-old female was admitted to an inpatient psychiatric unit for treatment of a manic episode of bipolar I disorder. She had no previous history of a substance use disorder (SUD) and had no previous positive results on UDS tests spanning an 8-year period. However, her UDS obtained in the emergency department (ED) was positive for fentanyl. The patient adamantly denied that she had ingested anything other than her prescribed medications. Her outpatient psychiatric provider also endorsed that she had no previous known history of an SUD. It was suspected that the patient's treatment with ziprasidone prior to admission and in the ED contributed to this positive fentanyl result.
It has been established that risperidone may cause false positive fentanyl results on UDS. Due to structural similarities, ziprasidone may also cause this same result. As clinicians become more aware of the ubiquity of fentanyl in the illicit drug supply, it is imperative that clinicians also consider limitations of the currently available UDSs.
本病例报告的目的是强调第二代抗精神病药齐拉西酮可能导致尿液药物筛查（UDS）中芬太尼呈假阳性结果。
一名 70 岁女性因双相 I 型障碍的躁狂发作而被收入住院精神病病房接受治疗。她以前没有物质使用障碍（SUD）病史，并且在过去 8 年期间进行的 UDS 测试均无阳性结果。然而，她在急诊科（ED）进行的 UDS 检测呈芬太尼阳性。患者坚决否认她除了服用规定的药物之外还摄入了任何其他物质。她的门诊精神科医生也证实她以前没有已知的 SUD 病史。怀疑她在入院前和 ED 接受齐拉西酮治疗导致了这一阳性芬太尼结果。
已经确定利培酮可能导致 UDS 中芬太尼假阳性结果。由于结构相似，齐拉西酮也可能导致同样的结果。随着临床医生越来越意识到芬太尼在非法毒品供应中的普遍性，临床医生还必须考虑到目前可用的 UDS 的局限性。
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