Querying a Female Issue with Trileptal

[Blonde Angel]

Hey there..
is there any ladies on Trileptal? The reason I am asking is that my Daughters Trileptal dose has been increased to 600mg twice daily... This happened since April. The problem since then is that she has had monthly bleeding despite being on the Microlut (mini pill) and Monofeme (pill).

The pharmacist has explained to me that the increased dosage of Trilptal has interfered with the pills effectiveness that's why there's breakthrough bleeding.

The challenge I am facing is that my girl is quite distressed with menstruation.
Is there any other contraceptive pill that works well with Trilptal??
I am not keen to change the Trileptal as she has been generally quite stable with no sezuires for the last two and half months.I don't want to rock that boat really.

I am aiming to see the gynaecologist in August to discuss other options if the pills are not doing its job..something that's not too invasive for my daughter.
I'm aware of contraceptive implant but with Autism I'm sure that will drive her nuts...she will be irritated by anything new and probably scratch like mad the area concerned.
Any thoughts??onder:

 

[Nakamova]

If she needs stay on oral contraceptives then the best bet would probably be hormonal birth control pill with more than 50mcg/day of estrogens.

For b.c. I recommend the Mirena IUD -- no interactions with seizure meds and no periods either.

 

[Cint]

The pharmacist has explained to me that the increased dosage of Trilptal has interfered with the pills effectiveness that's why there's breakthrough bleeding.

A lot of the AEDs can/do interfere with hormonal issues for females. So can epilepsy itself. I know it did for me, but I'm much older than your daughter. I finally had surgery to stop my breakthrough bleeding and have gone thru menopause, although it was early menopause, starting in my 40's.

Read here for more info:
http://www.epilepsy.com/information/women/all-women/hormones-and-epilepsy

 

[Cint]

I am aiming to see the gynaecologist in August to discuss other options if the pills are not doing its job..something that's not too invasive for my daughter.
I'm aware of contraceptive implant but with Autism I'm sure that will drive her nuts...she will be irritated by anything new and probably scratch like mad the area concerned.
Any thoughts??onder:

And please, make sure her neurologist and ob/gyn+ all other docs are working together on this issue.

FromWebMD Home

Birth Control for Women With Epilepsy
(continued)

Reliable Birth Control When You Have Epilepsy

If you are taking a liver enzyme-inducing drug, and you want to use hormonal birth control, you should talk to your neurologist and your gynecologist. It is a good idea to use a second method of birth control as a backup. Barrier methods, like condoms, diaphragms, and new-generation IUDs, are good options.

In the past, doctors have sometimes prescribed higher-dose birth control pills to make up for the rapid breakdown of the contraceptive drug. That may work, but there is no clear research to tell us one way or the other. "Doctors used to say that increasing the amount of the estrogen in the pill took care of this problem," says Jacqueline French, MD, professor of neurology at New York University's Langone Medical Center and co-director of Epilepsy Research and Epilepsy Clinical Trials at the NYU Comprehensive Epilepsy Center. "But we have no data to confirm that."

In one case, hormonal birth control might make your anti-seizure drug less effective. That can happen if you are taking lamotrigine (Lamictal). The body's levels of Lamictal appear to be reduced when a woman takes hormonal birth control. "This is the only anti-seizure drug we know of that acts like that," says Mark Yerby, MD, MPH, founder of North Pacific Epilepsy Research in Portland, Oregon. "If Lamictal is controlling a woman's seizures very well, and she begins to take the pill, sometimes the seizure control is not as good." (Lamictal and other seizure medications can also become less effective when a woman is pregnant.)

And as you think about what kind of birth control is right for you and do your planning, it's important to talk with your neurologist and your gynecologist. Both of these doctors should be very involved in your care. Each of them needs to know about the drugs or treatments that the other prescribes.

 

[valeriedl]

Before and after I was diagnosed with epilepsy I was taking Depo-Provera (the shot) for birth control.

Two of the main reasons I took it, other than as a contraceptive, was because I had horrible cramps and heaving bleeding. On Depo-Provera you don't have a period. I think (my memory's not quite that great) I might have had some light spotting but it was very rare.

Both my neuro and gyno said it was ok to take with the epilepsy meds I was taking, make sure you ask that first. The amount of seizures I had a month didn't change when I stopped taking it so I know it wasn't something that caused seizures for me.

 

[Blonde Angel]

Thanks Nak, Cint and Valeriedl.. for your feedback..

The Mirena IUD is going to be the long term thing, but its going to be suitable when she is an adult. The gyno recommends hormonal stuff first.

Yes, Cint you are correct in stating that all the Drs that I see need to be informed about the medication interactions and I usually ask "does this drug affect this ?" We see a Developmental Paediatrician, Neuro, and the Gyno . So I find I have to be very aware for my girls specific needs and challenges.

Val.. Depo-Provera involves a intramuscular injection, unfortunately that's not going to be an option as to do even a blood test she needs a general anaesthetic. She is very strong and can get physically violent to others. Not really worth the drama in a Drs room..

Will aim for another type of Pill with more estrogens as Nak mentioned.

Thanks Cint for the info..
I will check it out.

Its a tough job getting these meds right and its interactions...you think its ok until something like a dosage change mucks it up... so frustrating ATM
But I will through this...
Take care
x

 

[valeriedl]

Val.. Depo-Provera involves a intramuscular injection, unfortunately that's not going to be an option as to do even a blood test she needs a general anaesthetic. She is very strong and can get physically violent to others. Not really worth the drama in a Drs room..

Is she afraid to have a shot or is there another reason?

 

[AlohaBird]

"it's important to talk with your neurologist and your gynecologist. Both of these doctors should be very involved in your care. Each of them needs to know about the drugs or treatments that the other prescribes."

Pfffttt! I had been on the pill for 7 years when I started having seizures. Nobody in either doctor's office ever once asked this question.

 

[Blonde Angel]

Yeah
You always got to be on top with the Docs they always do their own damn thing. They specialize in this or that and never like to really rock each others space.
All these drug interactions do not get the attention it deserves sometimes I feel, it can make life hell and it can be something so simple or trivial.

 

[Blonde Angel]

Val
Not worth going there..... it would be distressing for her and me..

 

[valeriedl]

I believe there is some type of patch, like a band aide, that you can wear. You could ask your gyno about that.