This study describes a method for the quantification of multiple toxicologically relevant compounds in plasma samples from suicide attempt patients using an automated three-step solid-phase extraction (SPE) with hydrophilic-lipophilic balance (HLB®) sorbent, with subsequent analysis by liquid chromatography-tandem mass spectrometry (LC/MS-MS). This novel approach simplifies the standard five-step SPE process by eliminating the conditioning and equilibration steps. Target analytes included amitriptyline, amphetamine, benzoylecgonine, carbamazepine, cocaethylene, cocaine, codeine, diazepam, fluoxetine, 3,4-methylenedioxymethamphetamine (MDMA), N-methyldiethanolamine (MDEA), methylenedioxyamphetamine (MDA), methamphetamine, morphine, nortriptyline, paroxetine, sertraline, and venlafaxine. Plasma samples (100 µL) were diluted with 4 % phosphoric acid in water, mixed with deuterated internal standards, and subjected to automated SPE using an ASPEC® automation. Analysis was performed using an octadecyl column (1.8 µm, 150 × 2.1 mm) with a 15-minute chromatographic run. The automated SPE took 24 min per sample. Intra-assay precision was 1.6–10.1 %, inter-assay precision was 1.5–5.8 %, and accuracy was 94.4 %–106.6 %. Extraction yields varied from 14.6 % to 78.7 %, with matrix effects ranging from −15.9 % to 13.3 %. The validated method was applied to samples from 50 suicide attempt patients, of which 28 contained quantifiable amounts of the target substances. This study describes the first application of an automated three-step SPE procedure for the extraction of multiple relevant analytes in emergency toxicology
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