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Anyone looking to use several kinds of prescription or non-prescription medications in combination should be aware of the potential for interactions between these drugs — some drugs render others less effective, for example, while others have the opposite effect. Women taking anti-seizure medications for epilepsy who also wish to prevent pregnancy are best off coordinating their medical regimes with both healthcare providers involved. In general, however, here are some things you need to know about how anti-seizure medications and hormonal birth control methods may interact. 

Some Anti-Seizure Medications Make Your Birth Control Less Effective

Enzyme-inducing anti-epileptic drugs (AED), including but not limited to phenobarbital, phenytoin, carbamazepine, and topiramate, have been demonstrated to speed up the metabolism of ethinylestradiol and progestogens, hormones contained in many contraceptives. 

This does not make it unsafe for you to use hormonal birth control methods such as the birth control pill, the birth control injection, or the Mirena IUS, but it does mean that your hormonal birth control may be less effective — in other words, that your risk of becoming pregnant despite using birth control increases. Levonorgestrel implants such as Jadelle  are not considered suitable for women taking enzyme-inducing AEDs, because the risk of failure is simply too high. Pill wise, however, there may be a simple solution — making sure that your pill contains a minimum of 50 microg of ethinylestradiol. 

There are also anti-seizure drugs that work in the opposite way, increasing the levels of hormones contained in your contraception that remain within your body. These two are felbamate and valproate. 

Lamictal: An Anti-Seizure Drug That Can Be Rendered Less Effective If You Take Birth Control

While many anti-seizure drugs make your birth control less effective, there's only one anti-seizure drug that is currently known to become less effective if you use hormonal contraceptives. This medication is Lamictal (Lamotrigine), a non-enzyme-inducing anti-seizure drug. Though the mechanism isn't quite clear, using hormonal birth control can lower the amount of this medication found in your blood stream, leaving you more vulnerable to seizures. In addition, Lamictal can also make the progesterone found in many contraceptives less effective. 

What Do You Need To Know Before You Choose A Contraceptive If You Have Epilepsy?

Women with epilepsy who wish to use one of the many forms of hormonal birth control on the market today should be sure to mention their epilepsy to the healthcare provider prescribing the contraception. Even better, mention the fact that you are planning to start using a hormonal contraceptive to the doctor prescribing your anti-seizure drugs as well, and see if the two can consult to decide which options are best for you. 

There are certainly anti-seizure meds that do not interact with hormonal contraceptives, such as Gabapentin and Clobazam for example, so depending on what your medication regime is like, you may not have any problems at all. 

You could also consider non-hormonal contraceptives, but... any woman considering using hormonal contraception probably isn't all that interested in condoms, and barrier methods are not very effective as stand-alone contraception. That leaves the copper IUD as a very effective and long-term non-hormonal contraceptive. 

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