Worshippers take part in afternoon prayers on the last Friday of Ramadan at the Baitul Islam Mosque in Vaughan, Ont., prior to Canada Day festivities on Friday, July 1, 2016. A Canadian psychiatrist is taking the lead on advising doctors to help address the needs of mentally ill Muslim patients whose medication regimen could be affected by fasting during the upcoming religious observance of Ramadan. THE CANADIAN PRESS/Cole Burston

Canadian psychiatrist advises doctors on how to help patients during Ramadan

He’s worried about what fasting could do to medication intake

A Canadian psychiatrist is advising doctors to help address the needs of mentally ill Muslim patients whose medication regimen could be affected by fasting during the upcoming religious observance of Ramadan.

Dr. Zainab Furqan, a psychiatry resident at the University of Toronto, said about a billion Muslims around the world participate in Ramadan each year but there’s little research about fasting among patients dependent on psychiatric drugs.

She said physicians should consider the timing and dosing of medication for patients abstaining from food and water between sunrise and sunset during the annual month-long observance, which this year begins on Monday in Canada.

Furqan is the principle author of a commentary published Thursday in the journal Lancet Psychiatry.

She is among six contributors, including Dr. Juveria Zaheer of the Centre for Addiction and Mental Health in Toronto and others from the Stanford University School of Medicine in California and the University of Manchester in the United Kingdom.

“Muslim doctors might have more context about what Ramadan is and how it’s practised but they may not be aware of some of the nuances related to psychiatric issues,” Furqan said, adding general stigma about mental illness could also play a role in the type of advice patients get about fasting from various sources, including religious leaders.

Some of the issues physicians should address include how the absorption of a particular drug is affected by food and whether a sedating medication could interfere with a patient’s ability to wake up for the pre-dawn meal, she said.

“We encourage doctors to think about things like: Are there medications that come in once-daily dosing rather than multiple times a day? Or are there medications where the timing of the administration needs to be changed?”

Concerns about dehydration should also be considered for patients taking medication such as lithium for bipolar disorder, Furqan said, adding someone who isn’t drinking water for 17 hours may need to be monitored more closely.

She said unlike physically ill patients, those with a mental illness are often unclear on whether they would be exempt from fasting as permitted by their religion for ill people who would be endangering their health by not eating or drinking for so long, especially when Ramadan is observed during summer.

Furqan, who will not be fasting this year because she is pregnant, said some people choose to do so despite exemptions for expectant mothers, the elderly and those who are ill.

“There are some people who are exempt from fasting, who choose to fast anyway and at times it’s not safe for them to do so,” she said, adding Muslims are allowed to substitute fasting during Ramadan with prayer, fasting later or charitable work instead.

“If there’s clear medical advice to patients then I think they would take that into consideration when choosing to fast or not. But I wonder how many of these frank conversations are actually occurring between doctors and their patients?”

READ MORE: Kelowna Muslim student says deadly New Zealand attacks ‘hits close to home’

Ali Reza Ladak, a lecturer at the Faculty of Pharmaceutical Sciences at the University of British Columbia, said health-care providers need to have an open, respectful discussion with patients in developing a medication plan, especially if those who are exempt decide to fast because they may not be aware of how it would affect their health.

Ladak said some patients, including those with chronic conditions such as diabetes and high blood pressure, may not think they have an illness but need to understand the long-term effects of not taking their medication or interrupting their usual schedule.

The Qur’an makes it clear that “God wills that you shall have ease and does not will you to suffer,” he said, reading an English translation of the Muslim holy book.

Fasting is seen as a test but some people might consider their illness a test as well, said Ladak, who is also a practising pharmacist.

“There’s a fine line there. If it’s going to be harmful for you, if you’re pregnant and it’s going to be harmful for the child you’re not supposed to fast.”

Ladak called Ramadan a “magical” time of reflection and said people want to be part of the experience that involves time with family and their community, so some Muslims may put pressure on themselves to fast when their health should be a priority.

READ MORE: Protective human chain forms around B.C. mosque for Friday prayer

Camille Bains, The Canadian Press


Like us on Facebook and follow us on Twitter.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Campbell River RCMP issue statement in support of a peaceful rally and against racism

The Campbell River RCMP issued a statement in support of a peaceful… Continue reading

Vancouver Island’s current COVID-19 case count officially hits zero

Of the 130 recorded Island Health cases, five people have died, 125 recovered

Campbell River karate instructor takes lessons outside the dojo

Northwest Shito-Kai’s Nigel Nikolaisen embracing alternative teaching methods during pandemic

Nine passengers on first flight after Campbell River airport reopens

Pacific Coastal flight 715 arrived from Vancouver on Tuesday morning

Danger tree removal work in progress along Sayward Highway 19

Delays up to 30 minutes expected between 7 a.m. to 1 p.m. on June 5

MAP: Dr. Henry reveals which B.C. regions have seen most COVID-19 cases

B.C. health officials release a first look at how the novel coronavirus has reached all corners of the province

Facing changes together: Your community, your journalists

The COVID-19 pandemic has changed the world in ways that would have… Continue reading

Mirror business directory and map

If you’d like to be added to the list, shoot us an email

‘I’m pissed, I’m outraged’: Federal minister calls out police violence against Indigenous people

Indigenous Minister Marc Miller spoke on recent incidents, including fatal shooting of a B.C. woman

Plan in place for BC Ferries to start increasing service levels

Ferry corporation reaches temporary service level agreement with province

B.C. starts to see employment return under COVID-19 rules

Jobless rate for young people still over 20% in May

Alert Bay resident carves tribute to his community kicking COVID-19’s butt

‘Our little village crushed the curve with love and commitment’

End of an Era: Tofino hair studio closes shop

“We were getting excited to start ramping up and then all of sudden we had to close our doors.”

Kelowna Mountie on desk duty following ‘aggressive’ arrest

The officer involved in an arrest that took place on May 30 in Kelowna has been placed on administrative duties

Most Read