The Clozapine Consultation Clinic at Johns Hopkins Hospital offers a one-time, second opinion evaluation for patients with schizophrenia who may benefit from clozapine. Referrals may be initiated by patients, family members, care providers, or treating clinicians. Example questions or reasons for consultation include:

1. Would clozapine be a reasonable medication choice for me/my family member/my patient?
2. We have heard that clozapine can be helpful, but have concerns about the potential risks. We would like to learn more.
3. I have recommended that my patient start clozapine, but they are reluctant. The consultation may be valuable in their decision making.
4. My patient tried clozapine, but experienced some side effects. Can we safely try this medication again?

Why Clozapine?

It is estimated that 30% of patients with schizophrenia do not fully respond to commonly used antipsychotic medications. For many of these patients, the antipsychotic clozapine has been shown to be a very effective treatment, with improvements in overall functioning and quality of life, and a decreased risk of suicide and aggression. Clozapine may also be of value in some patients who do respond well to standard antipsychotics but suffer from troublesome side effects. Despite these benefits, clozapine is underutilized, likely because of concern about side effects, blood work monitoring requirements, and administrative requirements for prescribers.

Components of the Consultation

• The consultation provides an in-depth evaluation to review current and past symptoms, diagnosis, treatment, side effects, and the goals and preferences of the patient, family, and treating clinicians.
• Prior to the clinic visit, patients and family members will be asked to provide medical records and to complete questionnaires about their history, symptoms, and treatments. Treating clinicians will be asked to provide a short summary of current treatment and concerns.
• The clinic visit typically lasts approximately 3 hours, and includes an in-person interview and examination of the patient, along with an interview of at least one family member.
• Consultants will communicate with treating clinicians before and after the consultation, and a detailed written report will be provided to the treating clinicians, patient, and family as appropriate.

If clozapine is a viable treatment option, the patient, family, and care providers will receive extensive education about the medication. The patient’s psychiatrist and other clinicians will receive advice and support concerning initiation of clozapine, management of adverse effects, and administrative requirements.

Consultation Clinic Faculty

• Allison S. Brandt, M.D.
• Russell L. Margolis, M.D.
• Frederick C. Nucifora, Jr, D.O., Ph.D., M.H.S.

Scheduling the Consultation Session

1. Complete the New Patient Demographic Form (pdf)
2. Complete the Clozapine Consultation Clinic Patient and Family Questionnaire (word document)
3. Complete the Authorization for Release of Health Information (pdf)
4. Request a typed treatment summary from your psychiatrist or your referring clinician. (Please stress to your doctor that we need more than notes from individual sessions. We ask for a summary to give our clinicians insight about your care which may not be communicated in progress notes. Please send your clinician the completed JHH authorization form, the consultation clinic letter and the sample letter.)
5. Once the documents are prepared, send them to the clinic fax at 443-769-1217 or via email at [email protected]
6. Finally, please review our billing information sheet under the insurance section in the patient demographic form and provide a clear picture of your insurance card. (Both front and back sides)

Contact Us

Clinic hours: 9 am - 4 pm
Clozapine Consultation Clinic
The Johns Hopkins Hospital
Osler 320
600 North Wolfe Street
Baltimore, MD 21287
Phone: 410-614-3307
Fax: 443-769-1217
E-mail: [email protected]
Directions to the Johns Hopkins Hospital
Directions to Osler Building (pdf)
Comprehensive Accommodations List (pdf)

• Scheduling an Appointment: Please call 410-955-5212 to speak with a member of our staff.
• International Patients: Please contact the Johns Hopkins Medicine International: 410-955-8032
• Assistance with Travel and Accommodations: Please contact Johns Hopkins USA: 410-735-4872