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Clozapine Clinic – Physical Treatment Centre, Hadrian Clinic – Patient Information Leaflet

This leaflet is for people who are attending a Clozapine Clinic. It is a regular clinic for the monitoring of Clozapine therapy, which involves taking a blood sample and checking for side-effects and any physical health problems.

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This leaflet may not be reproduced in whole or in part, without the permission of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

This leaflet is relevant to the following clinics:
• North Shields Community Mental Health Centre
• Oxford Centre, Long Benton Community Mental Health Team

  • Who is this leaflet for?

    This leaflet is for people who are attending a Clozapine Clinic. In it, we will try to answer some of the questions that you may have about Clozapine and attending the clinic. Your doctor will explain your individual treatment plan, how it could help you and will agree the plan with you. The benefits of Clozapine, how you will obtain repeat prescriptions, and side effects will be discussed with you. Any possible alternative treatments will also be discussed.

    You should tell your prescribing doctor of any other medications you are currently taking.

  • What is a Clozapine Clinic?

    It is a regular clinic for the monitoring of Clozapine therapy, which involves taking a blood sample and checking for side-effects and any physical health problems. The central base for the Clozapine service, and other physical treatments in the Newcastle and North Tyneside localities of the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust is at the Hadrian Clinic, Campus for Ageing and Vitality, Newcastle. The times of the clinics are as follows:

    • North Shields Community Mental Health Centre - By appointment
    • Oxford Centre Community Mental Health Team - By appointment

    You may discuss with the nurses at the clinic or person referring you, which particular clinic you would prefer to attend. You may attend at any time during opening hours.

  • Interpreters

    Interpreters can be arranged by clinic staff if required.

  • Where are we?

    We are based on the second floor of the Physical Treatment Centre in the Hadrian Clinic on the Campus for Ageing and Vitality, Newcastle.

    You can contact us on 0191 246 8665.

    The answering machine will be on to take your call out of hours, or if staff are busy in clinics. If so, please leave your name, contact number and a short message and we will ring you back as soon as possible.

  • Our main office is located at:

    Physical Treatment Centre
    Hadrian Clinic
    Campus for Ageing and Vitality
    Westgate Road
    Newcastle upon Tyne, NE4 6BE

  • The addresses of our outlying clinics are:

    Oxford Centre Community Mental Health Team
    North Tyneside CMHT
    West Farm Avenue
    Tyne and Wear
    NE12 8LT

    North Shields Community Mental Health Team
    26a Hawkeys Lane
    North Shields
    Tyne and Wear
    NE29 0PN

  • What is Clozapine?

    Clozapine (brand name Denzapine currently used within Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust) is an antipsychotic drug used in the treatment of people with schizophrenia. It should only be used when at least two other drug treatments have not worked.

    Clozapine interacts with receptors in the brain, which control the activity of chemical messages. These receptors are over active in people with schizophrenia and Clozapine decreases their activity.

    Clozapine tablets do not have any special storage requirements.

  • Are there any side effects of Clozapine?

    Some common side effects are:
    • feeling sleepy or drowsy
    • producing extra saliva (spit) and dribbling (alternatively, you may notice a dry mouth)
    • loss or increase of appetite
    • constipation

    It is important to remember that everyone is different so may react differently to medication. The leaflet ‘What to expect from Clozaril…’ gives more information on side effects.

    You should let clinic staff know of any side effects you are experiencing. You will be asked about side effects by the staff when you attend for bloods to be taken.

  • Why is Clozapine only used in a restricted group of people?

    Clozapine is a proven, effective treatment, but it can occasionally reduce the number of white blood cells in your body, which are responsible for fighting infection. These are called neutrophils and a fall in the number of these cells can lead to a condition called neutropenia. Whilst on Clozapine the blood tests you will have are required to check the number of white blood cells in order to detect any changes early before they cause problems. You will not be allowed to receive Clozapine unless you have an up-to-date blood result.

    If the cell levels are very low, you may be at risk of developing a very serious infection. Please refer to the leaflet “Your Journey with Denzapine suspension and tablets’’ for further information regarding this.

  • Why has Clozapine been prescribed for me?

    Clozapine can help to reduce unpleasant symptoms such as hearing voices, having strange and frightening thoughts and experiencing worrying changes in your behaviour. It can help those people for whom other medication has not been fully effective.

  • What happens when I attend the Clozapine Clinic?

    A blood sample is taken by one of our staff. This is usually processed by a blood analysis machine sited in the clinic. This result is forwarded electronically to the Clozapine Patient Monitoring Service (CPMS) and categorised using a traffic light system - Green - Amber - Red

    If the result is:
    Green, your medication, which is pre-dispensed by our pharmacy department, will usually be given to you in the clinic.
    • An Amber result means you may be given your medication but asked to return to the department for additional blood checks until a green result is obtained.
    • A Red result means you would have to stop taking Clozapine immediately and again attend for additional blood tests until the result returns to green.

    The clinic staff will advise you of any abnormal results.

    You will need to inform the staff at any time if you have a high temperature as this may indicate an infection, which will require further investigation.

    If, at any time, you find you have more than a week’s Clozapine medication in hand at the time of your blood test appointment, please return these to the clinic.

    Your visit to the clinics should take no more than 30 minutes. However, during busy periods you may have to wait a little longer than this.

  • What happens if I miss a blood test?

    You will be given enough medication to last until your next appointment. If you miss your appointment it is likely that you are running out of medication. It is important to contact the Physical Treatment Centre as soon as possible to arrange another appointment. Also, if you miss your medication for any reason for 48 hours or more, you must contact your nurse or doctor immediately. Further advice is given in the leaflet ‘What to Expect from Clozaril…’ Novartis Pharmaceuticals UK Ltd. which is available at the Clozapine clinics or from your doctor and/or care coordinator.

  • What if I want more information?

    If you have any questions about your medication, please talk to your doctor or nurse. If you explain what your query is, they will either be able to help you themselves, or, will let you know who can give you the information. Please feel free to phone the Physical Treatment Centre at the Hadrian Clinic for information and advice – Tel: 0191 246 8665.

  • What if I have a comment, suggestion, compliment or complaint about the service?

    If you want to make a comment, suggestion, compliment or complaint you can:
    • talk to the people directly involved in your care
    • ask a member of staff for a feedback form, or complete a form on the Trust website www.cntw.nhs.uk (click on the ‘Contact Us’ tab)
    • telephone the Complaints Department 0191 245 6672
    • email complaints@cntw.nhs.uk Please note that information sent to the Trust via email is sent at your own risk
    • We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention.
    You can provide feedback in the following ways:
    - the quickest way for you to do this is to complete our short online survey at
    www.cntw.nhs.uk/poy
    - complete a Points of You survey, available from staff.

  • References

    ‘Your journey with Denzapine suspension and tablets’, Britannia Pharmaceuticals UK Ltd.

  • Other formats, references and review

    Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

    This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

    Published by the Patient Information Centre
    2019 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/340/0718 July 2018 V6
    www.cntw.nhs.uk Tel: 0191 246 7288

    Review date 2021