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

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

Above: Hailey McNabb, as the mad narrator and Logan Hendry, as Edgar Allan Poe, take centre stage in PSO’s virtual performance of Poe: Dreams of Madness, which wrapped up last weekend. Left: Klaudie Slosarkova plays the widow. (John Murray photos - submitted).
PSO students get dark with Edgar Allan’s woes

Virtual performance of Poe: Dreams of Madness draws a good crowd

Police say that a U-Haul truck abandoned in Cache Creek on Jan. 19 (pictured) was being used to transport equipment and supplies consistent with a fentanyl drug production operation. (Photo credit: Barbara Roden)
Rental truck abandoned in Cache Creek believed to be connected with fentanyl drug production

Police seized high end equipment, chemicals, and several firearms

A sign indicating a COVID-19 testing site is displayed inside a parking garage in West Nyack, N.Y., Monday, Nov. 30, 2020. The site was only open to students and staff of Rockland County schools in an effort to test enough people to keep the schools open for in-person learning. (AP Photo/Seth Wenig)
4 more deaths, 54 new cases of COVID-19 in Interior Health

This brings the total to 66 deaths in the region

The 100 Mile RCMP is currently looking for this man in connection with reports of a stolen vehicle. (Photo submitted)
Police seek ‘person of interest’ in truck theft

Vehicle went missing on Jan. 26 in 103 Mile.

Canim Lake Band remains in lockdown. (Martina Dopf photo)
Canim Lake Band grieves loss of second Elder due to COVID-19

Elder, who lived away from home, was ‘matriarch, a fierce protector’, Chief says.

Dr. Penny Ballem, a former deputy health minister, discusses her role in leading B.C.’s COVID-19 vaccination program, at the B.C. legislature, Jan. 22, 2021. (B.C. government)
B.C. holds steady with 407 new COVID-19 cases Tuesday

14 deaths, no new outbreaks in the health care system

Worker at Swartz Bay terminal on Monday, January 20, 2020. (THE CANADIAN PRESS/Chad Hipolito)
Ex-BC Ferries employee who says he was fired due to his race gets tribunal hearing

Former employee Imraan Goondiwala alleges ‘white surpremacy’ in the make-up of BC Ferries’ workforce

Rodney and Ekaterina Baker have been ticketed and charged under the Yukon’s Civil Emergency Measures Act for breaking isolation requirements in order to sneak into a vaccine clinic and receive Moderna vaccine doses in Beaver Creek. (Facebook/Submitted)
B.C. couple who travelled to Yukon for COVID vaccine ineligible for 2nd dose until summer

The province is ensuring those eligible to receive the vaccine get the second shot within 42 days

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

(File)
Mask dispute in court leaves Vancouver cop with broken leg

Man allegedly refused to put on a mask and resisted arrest

(Kraft Dinner/Twitter)
Kraft Dinner launches candy-flavoured mac and cheese just in time for Valentine’s Day

Sweet and cheesy treat will be here just in time for the cheesiest holiday of the year

SAR crews worked late into the night Tuesday to rescue an injured snowboarder in North Vancouver. (Facebook/North Shore Rescue)
Complicated, dangerous rescue saves man in avalanche near Cypress Mountain

North Shore SAR team braves considerable conditions to reach injured snowboarder

A Cessna 170 airplane similar to the one pictured above is reported to be missing off the waters between Victoria and Washington State. Twitter photo/USCG
UPDATE: No sign of small plane that went down in waters south of Vancouver Island

Searchers out on both sides of border between Victoria and Port Angeles

Most Read