ABSTRACT

Contraception is an important consideration for women with epilepsy. The pharmacokinetic interactions between antiepileptic drugs and oral contraceptives are biderectional. Steroid hormones and enzyme-inducing antiepileptic drugs are substrates for the cytochrome P450 enzyme system. As a result, the concomitant use of hormonal contraceptives and antiepileptic drugs may pose a risk for unexpected pregnancy and seizures. Intrauterine devices and barrier methods are appropriate to recommend for use in women using enzyme-inducing medications. Depot medroxyprogesterone acetate injections appear to be effective; however, they may not be the first choice due to serious effects. Oral contraceptives significantly increase the metabolism of lamotrigine. Therefore, women with epilepsy taking lamotrigine need to be monitored carefully.