Pharmacological treatment of the attention-deficit/hyperactivity disorder (ADHD) includes use of the psychostimulant amphetamine. Non-adherence to medication is a well-documented problem in ADHD treatment and a cause of treatment failure. The study evaluated the possibility of using oral fluid for compliance monitoring during treatment with lisdexamphetamine (Elvanse®). UPLC-MS/MS methods for general oral fluid drug testing, lisdexamphetamine and amphetamine quantification and chiral analysis of amphetamine were used. The applied measuring ranges were 1–500 ng/mL for amphetamine and 0.01–15 ng/mL for lisdexamphetamine. Amphetamine (racemic) was detected and quantified in 98 (96%) of the 102 samples. The concentrations ranged from 2 to 8410 ng/mL. In 17 of these, the chiral analysis demonstrated intake of illicit amphetamine because L-amphetamine was present. The median D- + L-amphetamine concentration in the compliant group was 280 ng/mL, while the median concentration in the non-compliant group was statistically higher, 1677 ng/mL. In the non-compliant cases where L-amphetamine was detected, the L/D-amphetamine ratios ranged from 0.75 to 13.1 with a median of 1.0. Lisdexamphetamine was detected and quantified in 76 of the 102 cases, which represent 79% of the 98 cases with detected oral fluid amphetamine. The concentrations ranged from 0.01 to 6895 ng/mL. Drug testing had a positive rate of 23% in patients not taking illicit amphetamine and 82% among non-compliant patients with detected L-amphetamine. In conclusion, the study demonstrated the value of measuring amphetamine with a chiral method to detect intake of illicit amphetamine and to perform drug testing in oral fluid as a mean for compliance monitoring.

注意缺陷/多动障碍 (ADHD) 的药物治疗包括使用精神兴奋剂苯丙胺。不依从药物是多动症治疗中一个有据可查的问题，也是治疗失败的原因。该研究评估了在赖氨酸安非他明 (Elvanse®) 治疗期间使用口腔液进行依从性监测的可能性。使用 UPLC-MS/MS 方法进行一般口腔液体药物检测、赖氨酸苯丙胺和苯丙胺定量以及苯丙胺的手性分析。应用的测量范围为 1–500 ng/mL 安非他明和 0.01–15 ng/mL 赖氨酸安非他明。在 102 个样品中的 98 个 (96%) 中检测到并量化了苯丙胺（外消旋）。浓度范围为 2 至 8410 ng/mL。在其中的 17 个中，手性分析表明摄入了非法苯丙胺，因为存在 L-苯丙胺。依从组的中位 D- + L-苯丙胺浓度为 280 ng/mL，而非依从组的中位浓度在统计学上更高，为 1677 ng/mL。在检测到 L-苯丙胺的违规案例中，L/D-苯丙胺的比率范围为 0.75 至 13.1，中位数为 1.0。在 102 例病例中的 76 例中检测到并定量了赖氨酸苯丙胺，占 98 例检测到口腔液苯丙胺的病例的 79%。浓度范围为 0.01 至 6895 ng/mL。在未服用非法苯丙胺的患者中，药物检测的阳性率为 23%，在检测到 L-苯丙胺的非依从性患者中，阳性率为 82%。综上所述，