Controversies in contraception for women with epilepsy

  title={Controversies in contraception for women with epilepsy},
  author={Sanjeev V Thomas},
  journal={Annals of Indian Academy of Neurology},
  pages={278 - 283}
  • Sanjeev V Thomas
  • Published 1 July 2015
  • Medicine
  • Annals of Indian Academy of Neurology
Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of… 

Figures and Tables from this paper

Contraception in women with epilepsy: Potential drug interactions between contraceptive hormones and enzyme inducing antiepileptic drugs
The co-administration of lamotrigine and oral hormonal pills is especially complicated by unpredictable interactions and requires several considerations, so the current guidelines for concurrent use of hormonal contraception and AEDs in WWE are reviewed.
Interactions Between Anti-Epileptic Drugs and Contraceptives: A Review
The different therapeutic options should be analyzed together with the epileptic patients in order to achieve and optimize the best goal for each one and practical recommendations for the management of contraception in epilepsy patients are offered.
Women’s Issues in Epilepsy
  • E. Bui
  • Medicine, Psychology
  • 2022
Important external hormonal influences may impact women with epilepsy particularly in the context of gender-affirming medications, hormonal replacement therapy, and fertility therapies, as well as pregnancy-related concerns around fertility, seizure destabilization, and antiseizure medication–associated teratogenicity.
Seizure Freedom in Patients with Dravet Syndrome with Contraceptives: A Case Report with Two Patients.
Two girls with Dravet syndrome are reported on, who gained seizure freedom under therapy with contraceptives, and it is unclear whether and how this observation can be used therapeutically.
Update on management of epilepsy in women for the non-neurologist
The interplay of the female hormonal state and epilepsy is complex and has to be taken in to consideration when managing women with epilepsy related to their role in reproduction.
Contraception, pregnancy, and peripartum experiences among women with epilepsy in Bhutan
Health care cost associated with the use of enzyme-inducing and non-enzyme–active antiepileptic drugs in the UK: a long-term retrospective matched cohort study
Patients in the UK who initiated epilepsy therapy with an EIAED appeared to be at higher risk of complications associated with enzyme induction, and in long-term matched cohort analyses, the median total direct health care cost associated with EIAed therapy was higher than with nEAAEDs.
Affektive Störungen in der Schwangerschaft
When assessing the risks and benefits of psychopharmacotherapy in women who are or wish to get pregnant, not only the exposure of the child to potentially teratogenic drug effects but also potential complications during or after pregnancy and long-term neuropsychological issues need to be addressed.
Contraception advice for women with epilepsy
A 22 year old student attends your practice asking for contraception. She has idiopathic generalised epilepsy diagnosed five years ago, which is controlled with lamotrigine. She does not plan to


Antiepileptic drugs and hormonal contraceptives in adolescent women with epilepsy
Although adequate seizure control is the critical requirement of an AED, the potential for interactions with hormonal contraception and the increased risk for endocrine disturbances caused by drugs that alter hepatic microsomal enzymes suggest additional potential advantages for AED treatment that does not affect these enzymes.
Reproductive history, sexual behavior and use of contraception in women with epilepsy.
Contraception for Women with Epilepsy
Antiepileptic drugs that induce hepatic enzyme activity may alter the metabolism of most hormonal methods of contraception, and this affects the contraceptive regime, and a review considers these interactions and offers advice about their management.
Variation in Lamotrigine Plasma Concentrations with Hormonal Contraceptive Monthly Cycles in Patients with Epilepsy
Summary:  Purpose: This is the first report comparing intrasubject lamotrigine (LTG) plasma concentrations between hormonal contraceptive (HC) intake and week‐off phases in epilepsy patients
Lamotrigine plasma levels reduced by oral contraceptives
Host factors affecting antiepileptic drug delivery-pharmacokinetic variability.
Multidrug resistance gene expression correlates with progesterone production in dehydroepiandrosterone-induced polycystic and equine chorionic gonadotropin-stimulated ovaries of prepubertal rats.
It seems that progesterone produced by the granulosa cells may act in an autocrine manner to induce the expression of Pgp, which is found in the preovulatory follicles, cystic follicle, and corpora lutea.
Women with epilepsy.
A 25-year-old woman presents to the clinic for management of her epilepsy and notes that her menstrual periods have always been irregular and she has not had a period for 2 months.
P450 gene induction by structurally diverse xenochemicals: central role of nuclear receptors CAR, PXR, and PPAR.
  • D. Waxman
  • Biology, Chemistry
    Archives of biochemistry and biophysics
  • 1999
P450 induction by xenobiotics may in some cases lead to a perturbation of endogenous regulatory circuits with associated pathophysiological consequences, leading to the proposal that these receptors may primarily serve to modulate hepatic P450 activity in response to endogenous dietary or hormonal stimuli.