Background: Muslims fast each year during the Holy Month of Ramadan. This rite has major socio-cultural consequences. The circadian rhythms, energy expenditure, body temperature and biological clock are also influenced by Ramadan fasting. The impact of fasting on patients with mental disorders has been little studied. The aim of this study was to assess the number of hospitalizations in psychiatry during Ramadan compared to the other months of the lunar year. Method: A cross-sectional and retrospective study was conducted at Razi hospital, the psychiatric hospital in Tunis. The following data over the five lunar years (1434–1438) was checked for: The monthly and the annual number of hospitalizations in the different departments of Razi mental health hospital in Tunis as well as the monthly and annual rates of different legal modalities of admissions. Results: An important decrease in the number of hospitalizations during Ramadan was observed each year followed by a constant increase during the following month. Ramadan was the only lunar month to have had a consistently below-average number of admissions. There has been a significant increase in the mean number of hospitalizations per month over the years. A general trend towards an increase in the proportion of enforced hospitalizations has been noted. Conclusion: Ramadan stands out not only on a religious but also on a social level. Our results add support to the usefulness of research on mental health and Ramadan in the psychiatric community.

Atypical antipsychotics are widely used in the treatment of bipolar disorder. 1 Lurasidone is one of the medications approved by the Food and Drug Administration for the treatment of bipolar depression, both as adjunct and monotherapy. 2 Similar to other medications in its class, lurasidone has been reported to induce mania in patients being treated for bipolar depression. 3,4 We present a case series of 4 patients that developed acute mania with lurasidone, an effect that appears to be dose-dependent.

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