title: Recommendations for the Treatment of Patients With Parkinson Disease During Ramadan.
abstract: OBJECTIVE
  Every year, Ramadan fasting is practiced by many Muslim individuals. In cases of chronic disease, religious texts allow fasting to be broken. However, many believers still want to fast even at the risk of damaging their health. To our knowledge, there are no published recommendations on the medical management of Parkinson disease (PD) during Ramadan. Effective treatments exist in PD and usually require several daily drug intakes. Apart from worsening symptoms, interrupting PD treatment might lead to a severe withdrawal syndrome.
  
  
  METHODS
  Although no specific studies on this topic have led to formal recommendations, we suggest some options for adapting the treatment for patients who fast during Ramadan. The general principle is based on switching the patient's treatment to an equivalent dosage of a dopamine agonist that can be administered once daily or by transdermal patch. However, such an option is only feasible for patients who require a moderate amount of PD treatment and can tolerate dopamine agonist therapy.
  
  
  CONCLUSIONS
  Because many patients with PD require regular multiple daily administration of dopamine-replacement medication, the management of Ramadan fasting is not easy. Switching the patient's treatment to an equivalent dosage of a dopamine agonist that can be administered once daily or by transdermal patch seems to be a reasonable option to consider for patients treated with a low-to-moderate amount of PD medication.
authors.affiliation: Centre Hospitalier Universitaire Nantes 2INSERM, Hôpital Laennec, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Damier
authors.affiliation: Department of Neurology, Ibn Sina Hospital, Kuwait4Department of Medicine, University of Kuwait, Al-Khaldiya, Kuwait.
authors.forename: Jasem
authors.initials: J
authors.lastname: Al-Hashel
mesh_terms: D019468:Disease Management; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005215:Fasting; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D007514:Islam; D010300:Parkinson Disease / Q000628:therapy*
chemical_list: D018491:Dopamine Agonists