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

CN train derailment cleared between Terrace and Prince Rupert

The CN mainline is now open, following a train derailment mid-way between… Continue reading

Trial finishes for suspect in Burns Lake man’s murder

Closing submissions concluded at the Supreme Court in Prince George on July… Continue reading

Lightning starts nine small fires on July 5-7

Several wildfires started in the Northwest Fire Centre region over the July… Continue reading

Mill blast safety measures review ends

The government is wrapping up a review on how industries and other… Continue reading

Know the rules before towing a recreational trailer

Motorists towing a recreational trailer this summer should be aware of the… Continue reading

VIDEO: Young couple found dead in northern B.C. had been shot, police say

Chynna Noelle Deese of the U.S. and Lucas Robertson Fowler of Australia were found along Highway 97

VIDEO: Man found dead near B.C. teens’ truck could be linked to a double homicide

RCMP said they are looking for Kam McLeod, 19, and Bryer Schmegelsky, 18, of Port Alberni

Latest plan is to fly trapped fish by helicopter over Big Bar slide

Multi-pronged plan set in motion to freesalmon blocked by landslide in the Fraser River

Family of missing B.C. senior with dementia frustrated with situation, heartened by community support

Nine days since Grace was last seen the question remains: ‘How can an 86-year-old just disappear?’

Unsealed record suggests U.S. man convicted of murdering Vancouver Island couple left DNA on zip tie in 1987

William Talbott is set to be sentenced Wednesday in the murders of Jay Cook and Tanya Van Cuylenborg

Coast Tsimshian sign historic stewardship agreement

Lax Kw’alaams and Metlakatla plan to work as one to preserve traditional lands

Okanagan Air Cadet challenges gender-exclusive haircut policy

Haircut regulation inspires challenge around gender identity

VIDEO: Bystander training gains traction as tool to prevent sexual harassment, violence

Julia Gartley was sexually assaulted after an event, and no one stepped in to help

Two brands of ice cream sandwiches recalled due to presence of metal

The Canadian Food Inspection Agency issued a recall on Iceberg and Originale Augustin brands

Most Read