{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:09:07Z","timestamp":1784268547360,"version":"3.55.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The study evaluated loss due to adsorption of selected antipsychotic drugs in serum samples collected in blood collection tubes with and without separation gel using real clinical specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical serum specimens (n = 30 per drug) were obtained from paired blood collection tubes with and without separation gel. After clotting for approximately 2\u00a0h at room temperature, samples were centrifuged, and Day 0 drug concentrations were measured by LC\u2013MS\/MS within 2\u00a0h after centrifugation. To distinguish intrinsic analyte instability from separation-gel-associated loss, serum aliquots from both gel and non-gel tubes were stored in the dark in a monitored refrigerator set at 4\u00b0C, with recorded temperatures ranging from 3.6\u00b0C to 4.8\u00b0C, and reanalyzed on Days 2 and 7.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On Day 0, the concentrations of clozapine and aripiprazole were significantly lower in separation-gel tubes than in non-gel tubes, with mean relative reductions of 7.86% and 5.02%, respectively, although both remained within the predefined \u00b115% acceptance criterion. In non-gel tubes, clozapine remained stable during refrigerated storage, with residual concentrations of 99.1% on Day 2 and 98.3% on Day 7 relative to Day 0. In contrast, clozapine in gel tubes decreased to 95.0% on Day 2 and 89.6% on Day 7. The gel versus non-gel difference was significant on Day 7, with a mean additional loss of 8.7% in gel tubes compared with non-gel tubes (p &amp;lt; 0.001). Aripiprazole showed a lower concentration in gel tubes on Day 0 but no further time-dependent loss in either tube type during storage. No relevant loss was observed for the remaining antipsychotic drugs and metabolites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Under the tested conditions, most analytes showed no clinically relevant concentration loss during 7 days of refrigerated storage. Clozapine showed a measurable decrease in separation-gel tubes but not in non-gel tubes, suggesting an additional gel-associated contribution that may affect TDM interpretation near clinical decision thresholds. Aripiprazole showed an early tube-related difference without further storage-dependent loss. These findings should be interpreted within the evaluated tube brand, gel formulation, storage condition, and concentration ranges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1849104","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:44:28Z","timestamp":1784267068000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on the stability of antipsychotic drugs in clinical samples within serum collection tubes with and without separating gel"],"prefix":"10.3389","volume":"17","author":[{"given":"Wenjuan","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Xicheng District Pingan Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Xicheng District Pingan Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Beijing Xicheng District Pingan Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Xicheng District Pingan Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"He","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Anding Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Fuxing Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/a-2860-7861","article-title":"Consensus guidelines for monitoring neuropsychopharmacology therapeutic drugs: 2017 edition","volume":"25","author":"Hart","year":"2022","journal-title":"J Pract Drugs Clinics"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3969\/i.issn.1009-6574.2022.08.013","article-title":"Expert consensus on clinical application of monitoring of psychotropic drugs in China (2022 edition)","volume":"22","author":"Guo","year":"2022","journal-title":"J Neurol Ment Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.4155\/bio-2018-0155","article-title":"Schizophrenia: recent advances in LC-MS\/MS methods to determine antipsychotic drugs in biological samples","volume":"11","author":"Costa Queiroz","year":"2019","journal-title":"Bioanalysis"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-018-0664-3","article-title":"Clinical pharmacology of atypical antipsychotics: an update","volume":"13","author":"Mauri","year":"2014","journal-title":"EXCLI J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"31","DOI":"10.11613\/bm.2014.006","article-title":"Interferences from blood collection tube components on clinical chemistry assays","volume":"24","author":"Bowen","year":"2014","journal-title":"Biochem Med (Zagreb)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1097\/FTD.0000000000000901","article-title":"Review of the preanalytical errors that impact therapeutic drug monitoring","volume":"43","author":"Peck Palmer","year":"2021","journal-title":"Ther Drug Monit"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200008000-00011","article-title":"Time-dependent absorption of therapeutic drugs by the gel of the Greiner Vacuette blood collection tube","volume":"22","author":"Dasgupta","year":"2000","journal-title":"Ther Drug Monit"},{"key":"B8","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1097\/ftd.0000000000000592","article-title":"Substantial differences in serum concentrations of psychoactive drugs measured in samples stored for 2 days or more on standard serum tubes versus serum tubes containing gel separators","volume":"41","author":"Wollmann","year":"2019","journal-title":"Ther Drug Monit"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2021.1974400","article-title":"Therapeutic drug monitoring of clozapine in adults with schizophrenia: a review of challenges and strategies","volume":"17","author":"Molden","year":"2021","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"B10","volume-title":"ICH M10: Bioanalytical Method Validation and Study Sample Analysis. 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