Adverse side effects of lithium and fasting (Ramadan).

Objective: To find out adverse side effects of lithium in bipolar affective disorder patients in the month of Ramadan. Material and Methods: This descriptive study was carried out at the Department of Psychiatry, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from September to November 2006. Sixty two subjects were included in the study by non probability convenient sampling. The patients suffering from Bipolar Affective Disorder using Lithium were assessed on a check list of dose related side effects and toxicity signs resulting from Lithium. Results: Sixty two patients completed the pre Ramadan assessment while fifty seven and fifty six attended the mid-Ramadan and post-Ramadan assessment respectively. Majority of the patients were male (n=53), married (n=44) and on average had lower educational status (mean years of education = 8.02 + 4.5). Except weight gain (p-value = 0.006), there was no statistically significant difference in the adverse side effects of Lithium in pre-Ramadan (n=15, 24.2%) as compared to mid-Ramadan (n=4, 6.5%) period. The toxicity associated with Lithium did not differ significantly between the pre-Ramadan and post-Ramadan period. Conclusion: Following the routine protocol of the use of lithium, it can be safely prescribed without the undue fear of adverse side effects during Ramadan.