False-Positive Amphetamine/Ecstasy (MDMA/3,4-Methylenedioxymethamphetamine) (CEDIA) and Ecstasy (MDMA/3,4-Methylenedioxymethamphetamine) (DRI) Test Results With Fenofibrate

This case report describes a false-positive amphetamine/ecstasy [3,4-methylenedioxymethamphetamine (MDMA)] and ecstasy (MDMA) screen after therapeutic use of antihyperlipidemic drug, fenofibrate. A 60-year-old male patient was admitted to inpatient psychiatry unit with the diagnosis of alcohol dependency. He was prescribed diazepam 30 mg/day, thiamine 300 mg/day, and naltrexone 50 mg/day. He had also been using fenofibrate 267 mg/day for 3 years for hyperlipidemia and trazodone 100 mg/day for 5 months for insomnia. On routine, urine drugs-of-abuse screening amphetamine/MDMA (CEDIA) test was positive for 4 different occasions and MDMA (DRI) test was positive on 5 different occasions. Gas chromatography/mass spectrometry confirmation of the first positive 3 samples were negative for amphetamine and MDMA. After discontinuation of fenofibrate, amphetamine/MDMA, and MDMA immunoassay results turned out to be negative. Caution should be given to interpretation of amphetamine/ MDMA (CEDIA) and MDMA (DRI) tests in patients taking fenofibrate. Specific confirmation with a suitable method should be used to prevent erroneous interpretations.