Contraception

Women with epilepsy face unique challenges when choosing an appropriate contraceptive option. This is due mainly to antiepileptic medications (AED) being taken. Several AEDs interact with the birth control pill or other hormonal methods (including the Norplant implant and Depo-provera injection), making them less effective.

Medications which interact with hormonal contraceptives include:

Phenobarbital
Primidone
Phenytoin
Carbamazepine
Oxcarbazepine
Topiramate
Felbamate

If a woman is taking one or more of the above medications, all that is required to maximize contraception usually is to increase the dosage of the estrogen component of the pill, or to increase the frequency of replacing the Norplant or injecting the Depo-provera. However, most physicians recommend that additional non-hormonal methods of contraception be used, including barrier methods (condom and diaphragm) and/or intra-uterine devices (IUDs). In fact, medications which interact with the pill and other hormonally based contraceptive devices do NOT affect barrier methods, non-hormonal IUDs or other methods such as the rhythm method (though this method in particular is not recommended as a safe and effective method of contraception).