Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study

Abstract This prospective observational study aimed to investigate the effects of Ramadan fasting on serum lithium levels, renal function, and electrolyte balance in patients with bipolar disorder undergoing lithium maintenance therapy. Conducted in Saudi Arabia, a region characterized by hot and ar...

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Main Authors: Mohamed Abouzed, Abdullah Saleh Altuhayni, Salwa Rashed Alshammari, Mohamed Saad Almuqahhwi, Mohamed Elgernas, Abdulkarim Almazyadi, Abdullah Abdulaziz Alghuraymil, Yousef Ibrahim, Awwad Alenezy
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:International Journal of Bipolar Disorders
Online Access:https://doi.org/10.1186/s40345-025-00378-7
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author Mohamed Abouzed
Abdullah Saleh Altuhayni
Salwa Rashed Alshammari
Mohamed Saad Almuqahhwi
Mohamed Elgernas
Abdulkarim Almazyadi
Abdullah Abdulaziz Alghuraymil
Yousef Ibrahim
Awwad Alenezy
author_facet Mohamed Abouzed
Abdullah Saleh Altuhayni
Salwa Rashed Alshammari
Mohamed Saad Almuqahhwi
Mohamed Elgernas
Abdulkarim Almazyadi
Abdullah Abdulaziz Alghuraymil
Yousef Ibrahim
Awwad Alenezy
author_sort Mohamed Abouzed
collection DOAJ
description Abstract This prospective observational study aimed to investigate the effects of Ramadan fasting on serum lithium levels, renal function, and electrolyte balance in patients with bipolar disorder undergoing lithium maintenance therapy. Conducted in Saudi Arabia, a region characterized by hot and arid climates (30–36 °C, 25% humidity during Ramadan 2024), the study included 250 participants divided into fasting (n = 131) and non-fasting (n = 119) groups. Serum lithium levels, renal function parameters (serum creatinine and estimated glomerular filtration rate), and electrolyte levels (sodium and potassium) were assessed at baseline, mid-Ramadan, one month post-Ramadan, and three months post-Ramadan. Statistical analyses included mixed-effects models, linear regression, and Wilcoxon rank-sum tests. The results indicate that Ramadan fasting did not significantly alter serum lithium levels, renal function, or electrolyte balance across all time points. These findings suggest that fasting during Ramadan can be safely practiced by patients with bipolar disorder receiving lithium therapy, provided they maintain adequate hydration and adhere to their prescribed medication regimen.
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series International Journal of Bipolar Disorders
spelling doaj-art-0ec357d2501a4945810aa19636ca613c2025-08-20T02:32:00ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112025-05-011311710.1186/s40345-025-00378-7Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational studyMohamed Abouzed0Abdullah Saleh Altuhayni1Salwa Rashed Alshammari2Mohamed Saad Almuqahhwi3Mohamed Elgernas4Abdulkarim Almazyadi5Abdullah Abdulaziz Alghuraymil6Yousef Ibrahim7Awwad Alenezy8Psychiatry Department, Cairo Faculty of Medicine, Al-Azhar UniversityConsultant of Psychiatry, Erada Mental HospitalConsultant of Psychiatry, Erada Mental HospitalConsultant of Psychiatry, Erada Mental HospitalErada Mental HospitalPsychiatry resident, Erada Mental HospitalPsychiatry resident, Erada Mental HospitalPsychiatry Specialist, Erada Mental HospitalDepartment of Family and Community Medicine, Faculty of Medicine, Northern Border UniversityAbstract This prospective observational study aimed to investigate the effects of Ramadan fasting on serum lithium levels, renal function, and electrolyte balance in patients with bipolar disorder undergoing lithium maintenance therapy. Conducted in Saudi Arabia, a region characterized by hot and arid climates (30–36 °C, 25% humidity during Ramadan 2024), the study included 250 participants divided into fasting (n = 131) and non-fasting (n = 119) groups. Serum lithium levels, renal function parameters (serum creatinine and estimated glomerular filtration rate), and electrolyte levels (sodium and potassium) were assessed at baseline, mid-Ramadan, one month post-Ramadan, and three months post-Ramadan. Statistical analyses included mixed-effects models, linear regression, and Wilcoxon rank-sum tests. The results indicate that Ramadan fasting did not significantly alter serum lithium levels, renal function, or electrolyte balance across all time points. These findings suggest that fasting during Ramadan can be safely practiced by patients with bipolar disorder receiving lithium therapy, provided they maintain adequate hydration and adhere to their prescribed medication regimen.https://doi.org/10.1186/s40345-025-00378-7
spellingShingle Mohamed Abouzed
Abdullah Saleh Altuhayni
Salwa Rashed Alshammari
Mohamed Saad Almuqahhwi
Mohamed Elgernas
Abdulkarim Almazyadi
Abdullah Abdulaziz Alghuraymil
Yousef Ibrahim
Awwad Alenezy
Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
International Journal of Bipolar Disorders
title Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
title_full Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
title_fullStr Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
title_full_unstemmed Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
title_short Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study
title_sort short term and long term effects of muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder a prospective observational study
url https://doi.org/10.1186/s40345-025-00378-7
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