Clozapine in the news
You may have seen a report on Channel 4 News recently which highlighted the risks associated with drinking alcohol while taking clozapine. The combination of both drugs can cause central nervous system depression which is when the brain and nervous system slows down. If it slows down too much, it can be life-threatening.
We understand the report may be concerning for some of our patients and carers. If you have any worries, questions, or concerns about the use of alcohol with clozapine, please speak to your named healthcare professional/community mental health team who can provide advice and guidance on how to safely reduce and stop alcohol use. Do not stop taking clozapine, or alter your dose, without speaking to a doctor first – suddenly stopping or changing the dose of clozapine can also be hazardous to your health.
Like alcohol, there are other drugs and medicines which can cause central nervous system depression and therefore shouldn’t be taken with clozapine or only taken under medical advice. If you are concerned about anything you are taking while on clozapine, please speak to your named healthcare professional/community mental health team.
The symptoms of central nervous system depression are listed below. You should seek help immediately by calling NHS 111, or in an emergency attending A&E, if you are (or your relative is):
- oversedated or inappropriately sleepy;
- unusually confused or forgetful;
- un-coordinated, with slurred speech, slow reflexes or difficulty moving;
- breathing unusually slowly or have other breathing difficulties;
or if they have:
- a slow pulse or heart rate;
- dry mouth;
- blue lips; or
- clammy, cold skin.
Ensuring clozapine is used safely
Clozapine has a wide range of possible side effects, however for most patients the benefits outweigh potential risks when these are well monitored and managed. Our routine monitoring includes a holistic consideration of a patient’s lifestyle and its potential impact on treatment, including the use of alcohol, tobacco, caffeine and other drugs.
To minimise the risks and ensure clozapine is used safely and appropriately, we follow national guidance set by the Medicines and Healthcare Products Regulatory Agency (MHRA) and adhere to stringent monitoring and guidelines:
- It is mandatory to ensure side effects are monitored regularly and effectively, and all patients newly started on clozapine have regular monitoring and weekly blood tests. This is moved to twice a week after 18 weeks and then every four weeks after one year.
- All patients on clozapine are registered with a monitoring service and clozapine cannot be supplied unless monitoring and blood tests are up to date and within range. All medicines, and potential drug interactions, are considered when deciding whether to start clozapine or change the dose.
- During blood test monitoring, other aspects of physical health are also monitored for example checking for and treating constipation. Our patients attend clozapine clinics regularly for monitoring alongside their appointments with relevant clinicians.
- Patients and carers are given written information about clozapine and offered a discussion about the side effects, how they can be managed and the benefits of clozapine.
You can find detailed information about clozapine in our Patient Information Leaflet (PILL). This includes information on what the medication is for, how to take it, side effects and safety information. The manufacturer's Patient Information Leaflet can be found inside the box of your medication.
For further advice and support you can contact:
- Our Medicines Helpline on 020 3513 6829 to talk to one of our specialist mental health pharmacists. The helpline is open Monday to Friday from 9am-5pm.
- Your clozapine clinic to speak to a clozapine nurse
