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SupDock 10-11-2021 02:43 PM

Yeah, assuming all things you have said being true, this is a false negative.

Most likely from hook effect, and mass spectrometry should solve the issue.

There really isn’t a therapeutic window for Benzos, as it is generally symptoms driven. There are dosing guidelines though

TLO 10-11-2021 02:48 PM

Quote:

Originally Posted by SupDock (Post 15888265)
Yeah, assuming all things you have said being true, this is a false negative.

Most likely from hook effect, and mass spectrometry should solve the issue.

There really isn’t a therapeutic window for Benzos, as it is generally symptoms driven. There are dosing guidelines though

Well I'm going to sit down 1 on 1 with my doctor on Wednesday and discuss it with him.

I have printed off various reliable/ well respected resources to show him why a mass spectrometry test is warranted.

I'm also taking in my bottle of medication.

If they still won't do the MS test... :shrug:

Coach 10-11-2021 05:15 PM

My suggestion is, if they are not doing what you are asking them to do (and from what I am understanding, this isn't like a very dangerous stuff going on), I would say find a different doctor.

Some doctors are better than others and may have a better understanding of your case.

TLO 10-11-2021 06:12 PM

Quote:

Originally Posted by Coach (Post 15888580)
My suggestion is, if they are not doing what you are asking them to do (and from what I am understanding, this isn't like a very dangerous stuff going on), I would say find a different doctor.

Some doctors are better than others and may have a better understanding of your case.

Yeah man, but the wait list for a psychiatrist is CRAZY.

dlphg9 10-11-2021 07:03 PM

Quote:

Originally Posted by TLO (Post 15888102)
See the weird thing is that my number came back as 791 after they did the MS test last year.

This may be the problem. Found this in a study and have seen it in several different sources.

The immunoassay often uses an antibody to
oxazepam, a metabolite of diazepam and chlordiazepoxide.6,7
This antibody has relatively low cross reactivity with
clonazepam and lorazepam and is therefore less likely to be
detected reliably.

This is a different lab, but this is what Aegis Labs says

"A patient taking alprazolam, clonazepam, flurazepam, or lorazepam will not test positive for benzodiazepine metabolites on an Aegis report."

https://www.aegislabs.com/resources/...l-update/dec19

TLO 10-11-2021 07:15 PM

Quote:

Originally Posted by dlphg9 (Post 15888808)
This may be the problem. Found this in a study and have seen it in several different sources.

The immunoassay often uses an antibody to
oxazepam, a metabolite of diazepam and chlordiazepoxide.6,7his antibody has relatively low cross reactivity with
clonazepam and lorazepam and is therefore less likely to be
detected reliably.

This is a different lab, but this is what Aegis Labs says

"A patient taking alprazolam, clonazepam, flurazepam, or lorazepam will not test positive for benzodiazepine metabolites on an Aegis report."

https://www.aegislabs.com/resources/...l-update/dec19

I have that study printed off already to show my doctor. :clap:

Well, one of the numerous studies I found that say that exact same thing.

dlphg9 10-11-2021 08:03 PM

Quote:

Originally Posted by TLO (Post 15888856)
I have that study printed off already to show my doctor. :clap:

Well, one of the numerous studies I found that say that exact same thing.

Here's a good one too

https://www.google.com/url?sa=t&sour...J-clz4YxDQQ51S

False positive rates for benzodiazepine immunoassays are relatively low (<5 percent).
However, most benzodiazepine immunoassays used for screening are susceptible to false
negative results. The false-negative rate for benzodiazepines in an immunoassay screen is
approximately 25-30 percent, and is particularly problematic for clonazepam. One reason
for false-negative clonazepam results is that the drug appears in the urine almost entirely as
7-aminoclonazepam, a metabolite that is not detected by many commercial immunoassay
screens. A similar challenge exists for some other extensively metabolized benzodiazepines.
Concerns about false-negative results in confirmation/quantitation tests for
benzodiazepines also exist due to variation among laboratories in the cutoff concentrations
(sensitivity), the actual analytes detected, and the sample preparation methods. Regarding
sample preparation, some laboratory methods includes a sample pretreatment reaction prior
to analysis that liberates glucuronide metabolites (e.g., hydrolysis). Hydrolysis pretreatment
will improve detection of most benzodiazepines. Inclusion of multiple benzodiazepine
metabolites will also improve detection of benzodiazepines in urine confirmation/
quantitation tests.

TLO 10-13-2021 08:36 AM

Doctor flat said no to any other test. They have to follow the policies and procedures set by the administration. Anyone have any suggestions?

TLO 10-13-2021 07:51 PM

Healthcare is ****ed up


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