Resolving non-adherence to pharmacotherapy should involve a comprehensive assessment of the patient's social circumstances and cultural and religious beliefs (Reference Sattar, Ahmed and MadisonSattar et al, 2004). There is evidence that patients with strong spiritual values cope better with mental illness and have better insight into their condition. Such factors have a direct impact on treatment adherence and engagement in therapy (Reference Kirov, Kemp and KirovKirov et al, 1998).

Religious laws do not restrict the use of psychotropic medications but many forbid the use of animal-based derivatives, specifically gelatinous products and stearic acid. These are generally derived from beef and/or pork products. This has major implications for many patients, particularly the followers of Judaism, Islam, Hinduism, Buddhism, Seventh Day Adventism and the Christian Orthodox Church (Reference Sattar, Ahmed and MadisonSattar et al, 2004). There are also over four million vegetarians in the UK (Food Standards Agency, 2005).

Initial findings from a postal survey that we conducted locally suggest that many psychiatrists have remained ambivalent about discussing this subject with their patients, for fear of reducing adherence to psychotropic medication, and also that many are unaware of the presence of ‘forbidden contents’ in psychotropic medication.

We believe that, in order to instil a spirit of trust in our patients and improve medication adherence, psychiatrists should have a basic familiarity with religious dietary restrictions. Information on the gelatin or stearic acid content of medications can be obtained from the physicians' desk reference or electronic databases such as www.PDR.net or www.rxlist.com.