Clozapine toxicity and diet

name removed 23 Oct 2012 (Account suspended) made this Freedom of Information request to Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was partially successful.

name removed 23 Oct 2012 (Account suspended)

Dear Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment,

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 grateful to you for considering my FOI Request.

Yours sincerely,

[first name removed] [last name removed]

COT, Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment

Dear Ms [last name removed]

Thank you for your request for information under the Freedom of Information Act asking " 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.".

Your request was received on 8th January 2012 and I am dealing with it under the terms of the Freedom of Information Act 2000.

I will seek to deal with your request within 20 working days, but in any case will update you by 27th January 2012.

If you have any queries regarding this e-mail, please feel free to contact me.

Julie Shroff
Administrative Secretary
Committee on Toxicity of Chemicals in Food,
Consumer Products and the Environment
Room 3B, Aviation House
125 Kingsway, Holborn WC2 6NH

Tel: 020 7276 8522
Web: http://cot.food.gov.uk/
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name removed 23 Oct 2012 (Account suspended)

Dear Ms Shroff, COT,

Thank you very much for your acknowledgement and I look forward to receiving your response.

Yours sincerely,

[first name removed] [last name removed]

COT, Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment

1 Attachment

Dear Ms [last name removed]

Further to my email of the 9th January 2012, please find attached a reply to your FOI request.

Julie Shroff
Administrative Secretary
Committee on Toxicity of Chemicals in Food,
Consumer Products and the Environment
Room 3B, Aviation House
125 Kingsway, Holborn WC2 6NH

Tel: 020 7276 8522
Web: http://cot.food.gov.uk/
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name removed 23 Oct 2012 (Account suspended)

Dear Ms Shroff, COT,

Your Ref: {COT FOI /JS/ [last name removed]}

Thank you very much for your response to my Freedom of Information Request.

In your response, you refer to there being 3 references to Clozapine on your website.

Unfortunately they are not all available to the public, as one of the 3 references says it is "members" only. Thus, I would be most grateful to have this particular documentation - or the information from within it - as I believe that clozapine is potentially toxic and anything that you have by way of information on clozapine could well help many people to protect their health.

FOR MEMBERS' USE ONLY TOX/2001/28 COMMITTEE ON ... ... 3 (FMO3) polymorphism in a white population: allele frequencies, mutation linkage, and functional effects on clozapine and caffeine metabolism. ...
http://cot.food.gov.uk/pdfs/TOX-2001-28a...

The second reference is:
Variability and Uncertainty in Toxicology of Chemicals in Food ... Page 1. Committee on Toxicity of Chemicals in Food, Consumer Products
and the Environment March 2007 Variability and ...
http://cot.food.gov.uk/pdfs/vutreportmar...

The third refererence is
VARIABILITY AND UNCERTAINTY IN TOXICOLOGY ... Page 1. This is a draft COT working group report in the process of discussion.
It does not reflect the final views of the Committee ...
www.food.gov.uk/multimedia/pdfs/vutdraft...

but unfortunately this is only a "draft COT working group report... It does not reflect the final views of the Committee .."

and it is this specific information that I am requesting under Freedom of Information as it clearly is NOT available from anywhere else, just as the "members only" topic is unavailable to the public, and therefore I wish to have ALL the information that is known by the Committee please, and have it uploaded to the WhatDoTheyKnow website at http://www.whatdotheyknow.com .

It was because clearly the Committee clearly HAD discussed in some detail and at length Clozapine that I made my original FOI Request, having found these 3 references to which I made mention in my application.

In my original letter I requested, based on the fact that the COT had specifically referred to Caffeine and Clozapine:

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?

In your email response you write:

"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."

[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/vutreportmar...
http://cot.food.gov.uk/pdfs/TOX-2001-28a...

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/cot...

Unfortunately, the above link did not work for me, and I wonder if it could be made into a pdf document and placed on this charity website please?

I would like to have any information you have on Clozapine even if it is not regarding caffeine, as per my question 5.

If you can help me further with this, I would be most grateful.

Thank you very much,

Yours sincerely,

[first name removed] [last name removed]

COT, Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment

Dear Ms [last name removed]

Thank you for your email of 13 January, I will reply to you by 8 February 2012.

Julie Shroff
Administrative Secretary
Committee on Toxicity of Chemicals in Food,
Consumer Products and the Environment
Room 3B, Aviation House
125 Kingsway, Holborn WC2 6NH

Tel: 020 7276 8522
Web: http://cot.food.gov.uk/
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name removed 23 Oct 2012 (Account suspended)

Dear Ms Shroff, COT,

Thank you very much for responding and informing me that you will reply to me by 8 February 2012.

I must point out that I believe it to be a very important piece of evidence in view of the fact that several beverages and foods contain caffeine and people may be totally unaware of the dangers of taking a drink of coffee, tea or chocolate or eating a bar of chocolate whilst on Clozapine medication.

Where is the Black Box warning on Clozapine to state do not drink tea, coffee or chocolate unless they are decaffeinated?

In the light of this, may I ask that you liaise with the team who had the liaison partnership because it certainly is a significant finding is it not?

Thank you very much for your kind help,

Yours sincerely,

[first name removed] [last name removed]

COT, Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment

1 Attachment

Dear Ms [last name removed]
Further to my email of the 16th January 2012.
Please find attached a reply to your follow up FOI request email dated 13 January.

Julie Shroff
Administrative Secretary
Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment Room 3B, Aviation House
125 Kingsway, Holborn WC2 6NH

Tel: 020 7276 8522
Web: http://cot.food.gov.uk/
Help us to save paper- please think before you print this e-mail

show quoted sections

name removed 23 Oct 2012 (Account suspended)

Dear Ms Shroff,COT,

Thank you very much for your response.

The attachment you placed in html is extremely helpful, and is in good large font, perfect for study.

I am most grateful to you and your colleagues for making this information available,

Yours sincerely,

[first name removed] [last name removed]

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