Determination of 59 Psychotropic Drugs, Including Antipsychotics, Antidepressants, Antiepileptics, Anti-Alcohol Abuse Drugs, Anti-ADHD Drugs, and Their Metabolites in Urine Using LC–MS/MS for Medication Compliance Monitoring

Increasing social concern regarding individuals with mental health disorders in the criminal justice system has underscored the need for effective strategies to reduce recidivism. Medication compliance monitoring is a critical approach that ensures adherence to prescribed treatments, facilitating the reintegration of these individuals into society. This study focuses on the development and validation of a liquid chromatography–tandem mass spectrometry (LC–MS/MS) method for detecting 59 psychotropic drugs and their metabolites in urine, addressing a significant gap in existing monitoring techniques. Utilizing a dilute-and-shoot approach for urine sample preparation, we established a robust analytical method that demonstrated high sensitivity and precision, with limits of detection ranging from 0.07 to 1.5 ng/mL and correlation coefficients consistently above 0.997. The method was validated through various parameters, including selectivity, stability, and accuracy, ensuring reliable performance in forensic applications. Analysis of urine samples from 248 individuals on probation with mental health conditions confirmed the practicality of the method, identifying 53 psychotropic substances. The LC–MS/MS method was successfully applied for medication compliance monitoring of mentally disordered probationers. Therefore, this analytical method could provide clear evidence for preventing the recurrence of mentally disordered crimes.