This is an HTML version of an attachment to the Freedom of Information request 'Clozapine toxicity and diet'.





 
http://cot.food.gov.uk/ 
 
 
Ms R [last name removed] 
Our Ref: {COT FOI /JS/ [last name removed]} 
 
   
Thursday, 12th January 2012 
 
Dear Ms [last name removed] 
 
Request for Information  
 
Thank you for your email of 8 January 2012 to the Committee on Toxicity of Chemicals in 
Food, Consumer Products and the Environment (COT) requesting: 
“I am making a Freedom of Information Request regarding Clozapine, antipsychotic 
medication, as I note that on your website there are 3 references to Clozapine and 
caffeine. 
1] 
How does Clozapine affect the drinking and/or eating of caffeine-laden drink or 
 food? 
2] 
Why is it potentially toxic to mix drinking / eating of caffeine-laden drink or food 
 with 
Clozapine? 
3] 
What chemical reaction takes place in a person who is having Clozapine 
 
medication who drinks / eats caffeine-laden drink or food? 
4]  
Why is Clozapine not banned from being prescribed when caffeine is in so many 
foods that people could unwittingly be poisoning themselves by having a cup of 
tea or coffee or hot chocolate or a bar of chocolate or a cola drink with Clozapine? 
Many people drink and/or eat caffeine-laden drinks or foods and it could be very 
difficult to remove favourite foods and drinks from the diet just so that Clozapine 
could be taken - and in some cases, of course, it is forced into people who are 
under Section of the Mental Health Act 1983/2007? This might be a traumatic time 
for these people who at one stroke will be forced to take this toxic substance and 
at the same time be forced to stop eating and/or drinking caffeine-laden drinks 
and/or foods? 
5] 
In view of the known toxicology of Clozapine, has the Committee on Toxicity of 
Chemicals in Food, Consumer Products and the Environment produced a 
statement on Clozapine and diet? If so, please could you upload the link to it on 
this website http://www.whatdotheyknow.com so that the public may read it? 
Thank you very much.”  
 
 I am dealing with your request under the terms of the Freedom of Information Act 2000.  
 
The Committee on Toxicity of Chemicals in Food, Consumer Products and the 
Environment (COT) does not hold any information on the specific interaction between 
caffeine and clozapine. A search of the COT website brings up 2 references.  The first is 
in the report of COT sub-group on variability and uncertainty (VUT) and the second is in 
the title of a reference listed in a COT discussion paper on the reproductive effects of 
___________________________________________________ 
Room 3B Aviation House, 125 Kingsway, London WC2B 6NH 
Tel: 020 7276 8522  Email: [email address] 

caffeine; both refer to the effects of particular genetic polymorphisms (differences in the 
DNA sequence) on 1) an individual’s response to clozapine and, 2) to clozapine 
metabolism. In neither document is the specific interaction between caffeine and 
clozapine considered. Both documents can be downloaded from the COT website. 
http://cot.food.gov.uk/pdfs/vutreportmarch2007.pdf  
http://cot.food.gov.uk/pdfs/TOX-2001-28a.PDF  
 
In answer to your specific points 1- 4: 
 
Information on the side effects and interactions of pharmaceuticals and appropriate 
patient information is the responsibility of the Medicines and Healthcare Products 
Regulatory Agency (MHRA). They can be contacted at:  
MHRA, 151 Buckingham Palace Road, Victoria, London  SW1W 9SZ 
 
Point 5: 
 
The COT has not produced a statement on the interaction between clozapine and 
caffeine. In 2006, in conjunction with Committee on the Safety of Medicines a workshop 
was held on the general topic of diet and drug interactions, but the interaction between 
caffeine and clozapine was not specifically considered. The summary statement is 
available on the COT website. 
http://cot.food.gov.uk/cotstatements/cotstatementsyrs/cotstatements2006/cotstatement2
006dietdrug  
 
If you are not satisfied with the way the COT has handled your request for information, 
you should write within two calendar months of the date of this letter to the FSA 
Openness Team, and ask for an internal review.  They will arrange for the Complaints 
Coordinator to conduct the review.  Their address is Food Standards Agency, Room 2C 
Aviation House, 125 Kingsway, London, WC2B 6NH 
(email:[email address]). 
 
If you are not content with the outcome of the internal review, you may apply directly to 
the Information Commissioner for a decision.  Generally, the ICO cannot make a decision 
unless you have exhausted the complaints procedure provided by Agency.  The 
Information Commissioner can be contacted at: Information Commissioner’s Office, 
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF or through the website 
http://www.ico.gov.uk/. 
 
If you have any queries about this letter, please contact me.  Please remember to quote 
the reference above in any future communications. 
 
Yours sincerely, 
 
Julie Shroff 
Administrative Secretary 
Committee on Toxicity of Chemicals in Food, 
Consumer Products and the Environment