Woman with epilepsy discussing birth control options with partner

Birth control allows everyone, including people with epilepsy, the opportunity to make their own decision about if and when they want to become pregnant. When living with epilepsy, there are a few steps to take before choosing the correct birth control method for you. Some anti-seizure medications (ASMs) may interfere with your chosen birth control. This can make birth control less effective. Other birth control selections can affect certain ASMs. As a result, this may impact your seizure control.

Working with your healthcare team to select the correct birth control for you is crucial. Your team will review medications, your seizure history, and any other medical conditions you may have to help find the best choice for you.

As mentioned previously, some anti-seizure medications can make birth control less effective. This table offers a comprehensive look at ASMs by how strongly they interact with some forms of birth control.

Graphic showing anti-seizure medications that could make birth control less effective
Figure 1: Anti-Seizure Medications (ASMs) That Could Make Birth Control Less Effective

Some hormonal birth control options may be LESS effective at preventing pregnancy when they are paired with certain interacting ASMs (See Figure 1 above for the list of strongly and mildly interacting ASMs). If you do use one of these options, you should use an additional backup barrier method.

  • Combined (estrogen + progesterone) oral birth control pills (“the Pill”)
  • Vaginal rings
  • Estrogen patches
  • Progesterone-only pills (“mini-pill”)

Birth control that includes estrogen, such as birth control pills, the vaginal ring, and the estrogen patch, will lower the amount of lamotrigine in your bloodstream. It is also possible for this to occur with oxcarbazepine and valproic acid but to a smaller extent.

If the dose of lamotrigine is not adjusted when these birth control treatments are started, seizure control can worsen. This may also occur with oxcarbazepine and valproic acid.

Before taking birth control, reach out to your care team if you are taking lamotrigine, oxcarbazepine, or valproic acid. They will plan to monitor you and make any changes necessary to your dosage to make sure you maintain seizure control.

If you’re taking lamotrigine, oxcarbazepine, or valproic acid, and you’re thinking of discontinuing estrogen-containing birth control (combined oral contraceptive pills, vaginal rings, or skin patches), consult with your doctor about reducing your ASM dosage. We recommend that you have this conversation before you make any changes to your birth control.

Additional Information and Resources

Authored By:

Naymee J Velez Ruiz, MD FAES

on Thursday, December 07, 2023


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