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.

Just Posted

Campbell River city council won’t support cannabis license, citing First Nation opposition and ‘at-risk youth’ nearby

The third application to come before council is the first to be denied city support

Former Campbell Riverite reaches Everest summit

Clayton Matthews’ team got to the top of the world earlier this week

Campbell River RCMP arrest violent offender

Police struggle with suspect and take him down with a taser

Strathcona Regional District fiscal health gradually improving, staff say

Tax and service revenue was up for the SRD in 2018, while grant money was down

Rescuers finally persuade Eiffel Tower climber to come down

The official said the man was ‘under control and out of danger’ on Monday night

Oil companies, 24-cent gap between B.C., Alberta to be focus of gas price probe

Premier John Horgan called the spike in gas prices ‘alarming’

Motorcycle deaths spike 50% since 2017

Riders were most likely fatally crash on the weekends compared with the rest of the week

Mother of accused charged in death of Surrey teen girl found in torched SUV

Manjit Kaur Deo charged with ‘accessory after the fact’ in 2017 death of Surrey teen

Family of B.C. pilot killed in Honduras trying to ‘piece together’ tragedy

Patrick Forseth has a number of friends in the area and was loved by everyone

Justin Trudeau credits immigration for Canada’s growing tech sector

Trudeau stressed that Canada has become a major source of talent for tech all over the world

Feds launch tourism strategy designed to boost sector 25 per cent by 2025

The fund is supposed to back experiences that show off Canada’s strengths

Mamma Mia! poised to be biggest Chemainus Theatre show ever

Plenty of buzz as Island dinner theatre schedules ABBA-fueled romp

New book from Island author details social history of the E&N railway

Along the E&N tells the story of 32 establishments from Esquimalt to Campbell River.

Most Read