How do you adjust the management of epilepsy in patients who are planning to fast?

Great question! During Ramadan, Muslims fast from dawn to sunset. They can take their medications before dawn and after sunset. In most cases, they can continue their current bid regimen without having to change to extended-release. Remind them of the importance of maintaining a good sleep schedule as many may stay up late praying during this month.

I normally prescribe higher dosage at bedtime since 70% of abnormal activity occurs in sleep and patients can tolerate it better when they're sleeping. So during Ramadan, I often change the dosage, especially in summer when the nights are very short and the period of fasting is very long months of June and July.