Lycorine and galantamine are natural alkaloids found in Amaryllidaceae plants, such as narcissus. Narcissus leaves and roots are sometimes accidentally ingested because they resemble vegetables. Lycorine and galantamine are toxic and cause such effects as nausea, vomiting, and abdominal pain, when accidentally ingested. In a case of narcissus poisoning, the detection of lycorine and galantamine in biological samples is vital to determine whether they have been ingested. This study establishes a liquid chromatography-tandem mass spectrometry (LC/MS/MS) method to measure the lycorine and galantamine content of human serum, which can be used for mild to fatal poisoning cases. A serum pretreatment procedure was performed using acetonitrile and QuEChERS AOAC powder. The separation of the compounds was conducted using a pentafluorophenyl column, CAPCELL CORE PFP (2.1 mm I.D. × 100 mm, 2.7 μm). Lycorine, galantamine, and galantamine-d6 (internal standard) were identified by the transitions of m/z 288 → 147, m/z 288 → 213, and m/z 294 → 216, respectively. The calibration curves were linear in the ranges of 0.05 to 5 ng/mL and 5 to 100 ng/mL, with R2 > 0.999. The precision and accuracy were within the permissible range. The matrix effects of lycorine and galantamine were 94.3% - 98.4% and 87.8% - 91.1%, respectively. The extraction recovery rates of lycorine and galantamine were 101.9% - 112.7% and 95.6% - 107.1%, respectively. The present method detected lycorine and galantamine in the sera of three patients with mild poisoning that had accidentally ingested. This method is applicable in cases of lycorine and galantamine poisoning.
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