Can Epileptic Patients on Carbamazepine Safely Fast Ramadan?
Objective: To study the effect of fasting during Ramadan on the epileptic state of well-controlled epileptic patients taking the same protective doses of carbamazepine (CBZ) as they did before Ramadan.
Study design: A case series study including 40 epileptic patients in Mosul, Ninevah Province, Iraq, before Ramadan 1420 AH, which began December 9, 1999 CE. The patients were taking carbamazepine three times daily, and their epilepsy was well controlled. During Ramadan fasting, the same total daily amount of carbamazepine was administered, twice daily rather than three times daily. A blood sample was taken from each patient 10 days before fasting Ramadan and two samples on the 15th day of Ramadan, one at 9 a.m. (4 hours after the morning dose) and the second at 4 p.m. (1 hour prior to second dose). Serum CBZ concentration was measured by gas liquid chromatography, glucose was measured by glucose oxidase method, and sodium and potassium were measured by flame emission photometry.
Results: Statistical comparison between the means of CBZ concentration before Ramadan (control) and those of sample 1 (p> 0.1) and sample 2 (p> 0.5) during fasting in Ramadan showed no significant statistical differences. Also, there were no significant statistical differences between samples 1 and 2 during Ramadan (p> 0.1). The values of glucose, sodium, and potassium remained within their normal ranges during Ramadan.
Conclusion: The present study showed that epileptic patients taking continuous prophylactic doses of CBZ two times daily can safely fast Ramadan safely.
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