Tonic/Clonic vs Birth Control

[Atmosphere]

My wife has only had 7x TC seizures. So it's not "enough" to get to the bottom of it so easy according to the Neurologist.

We have an appointment for next week - however I wanted to know whether the last seizures last week could be related to her being on Birth Control for the 1st time ever. She's 24 and started off with Yaz (drospirenone and ethinyl estradiol). The side-effects of that stuff was mind boggling...I'm in the habit of always reading what could interfere with her 200mg Lamotrigine which she's been on for 5 years now, she started showing symptoms which a lot of women had that you researched about online. It also did not stop her menstruation, and she was spotting throughout the month. The following month we went to our GP again, and he then put her on something slightly stronger: Biphasil (levonorgestrel and ethinyl oestradiol).

Now I believe that apparently some of these hormonal medicines interact badly with an anti-epilepsy drug...and that sometimes the AED reduces the efficacy of the Birth Control pills... but that other birth controls reduces the AED's effectiveness and reduces it from eg 200mg to 100mg in reality.

What are your thoughts on this? Or is this purely a Neuro question? I'd like to be prepared before I ask her this next week. Because there is a chance that the 3 months of Birth Control has reduced the actual amount of AED in her system, and that over 3 months she stopped being as "immune" to a Tonic/Clonic, as she used to be prior to the Birth Control pills.

Thanks for the answers in advance!!

 

[Alma1986]

I have to say that I do believe that birth control and anti-epileptic drugs have some kind of interaction. I have tried all different brands of birth control pills and have had to stop taking them.. The last one I was on was Trinessa. I was doing ok for like 2 or 3 months before I started getting the most horrible side effects. Almost like having an aura for about 5 days. I literally called into to work about right before my period for 3 months. I couldnt drive and I felt like I was floating the whole time. I had a headache that lasted about 5 days one time. I was puking and I just literally felt drunk. I wanted to just sleep all day. I couldnt drive. Anyways, I got off it and now Im just on my seizure meds. I have read that birth control lowers the efficiecy of anti epileptic drugs and vice versa.

 

[epileric]

Here's one of the sites where you can look up interactions with medications and supplements.

http://reference.medscape.com/drug-interactionchecker

 

[Maidenminx]

When I was first put on anti spasmodics I had not long before that had an ius implanted. Because it's a direct system, the birth control drugs are delivered right where they need to be and therefore aren't interfering with anything else in the liver. The downside, they don't like to give it to women who haven't finished (or started) having children because there are risks.

 

[Kaitybugsmom]

Our daughters neurologist told us that birth control pills werent really an option while she was on Lamictal as it reduces the effectiveness of it (lamictal) and probably wouldnt achieve the seizure free we are looking for while taking the combo. Its not an issue at the moment because she's only 15. In the future we will have to pursue other options. I would be interested to hear others opinion on this. It seems that you can have a handful of neurologists, ask them all the exact same question and they will all answer it differently.

 

[Atmosphere]

Here's one of the sites where you can look up interactions with medications and supplements.

AHA!!!! Thanks for that website!!!

Here is what it said:

1 Interactions Found
Significant - Monitor Closely

ethinylestradiol + lamotrigine

ethinylestradiol decreases levels of lamotrigine by increasing hepatic clearance. Significant - Monitor Closely. Combination oral contraceptives have been shown to significantly decrease plasma concentrations of lamotrigine, likely due to induction of lamotrigine glucuronidation.



I knew that this stupid birth control stuff had some effect... my wife always seemed to have more "odd" behaviour towards the end of the orange pills.

BIPHASIL* tablets
COMPOSITION:
The eleven white tablets of BIPHASIL* contain 50 µg of levonorgestrel and 50 µg of ethinyl oestradiol.
The ten orange tablets contain 125 µg of levonorgestrel and 50 µg of ethinyl oestradiol.
The seven red tablets are inert.
The orange tablets contain TARTRAZINE.

I guess she should stop completely with this stuff and get a goalie!

Family practitioners and pharmacists should maybe try google! Because I have asked them MANY times to check on interactions!

 

[Cint]

Family practitioners and pharmacists should maybe try google! Because I have asked them MANY times to check on interactions!

They have their own google, a PDR- Physician's Desk Reference. Doctors don't tell every side effect because what effects one doesn't necessarily effect someone else.

Here is another website one can use to look up drugs: www.drugs.com/pdr

 

[Atmosphere]

They have their own google, a PDR- Physician's Desk Reference. Doctors don't tell every side effect because what effects one doesn't necessarily effect someone else.

You know what... I expect, as someone who is extremely concerned, that when I ask a pharmacist to check on that, because i'm worried... that at the VERY least he/she tells me: "Yes sir, with this drug combination some patients have issues, others have not. Please monitor closely!"

Definitely not: "Counteract Epilepsy Medication...??? No my dear I think that is an old wives tale, designed to make you not have premarital sex"

or

"No I don't see any problems"

Out of the 10 times I've asked specifically for them to check... not ONCE have they mentioned anything to me. When I asked my GP/Family practitioner, he just said: Pharmacists have a computer system, they check for you - just confirm with them when you get the medicine for alternatives.

If it's happened to us, I'm pretty sure it happens more than once a day!

 

[Cint]

Out of the 10 times I've asked specifically for them to check... not ONCE have they mentioned anything to me. When I asked my GP/Family practitioner, he just said: Pharmacists have a computer system, they check for you - just confirm with them when you get the medicine for alternatives.

If it's happened to us, I'm pretty sure it happens more than once a day!

onder: That's interesting....... because of the many drugs and problems I've had with them, I have asked my pharmacist and GP. On several occasion they have both referred to the PDR. Sounds like you need a different doctor.

 

[Atmosphere]

Maybe it's because we're out in africa... Maybe western methods are frowned upon!!!!


I'm just really glad, we got married on 11 Feb, and in December I phoned my Family Practitioner secretly and asked him if she could go on the pill with Epilepsy etc. His brother had epilepsy long ago, so i kind of felt in good hands. My Fiance at the time did not really want more pills... (just goes to show women are always right), but she also didn't know that we're going off to an island for the honeymoon, thinking we'll only do honeymoon in 2 years or so.

So I surprised her - but ultimately it ended up in her having 2x seizures in 1 day last week... She started on the birth control pills 3 months ago... and drugs.com clearly states:
The contraceptives reduced plasma levels of lamotrigine by 41% to 64%, and a deterioration in seizure control was observed several days to two months after initiation of contraceptive use, necessitating an increase in lamotrigine dosage or discontinuation of the contraceptive. In some cases, contraceptive discontinuation led to lamotrigine toxicity that required dosage reduction. A pharmacokinetic study also reported similar reductions in lamotrigine plasma levels in patients on combination oral contraceptives, with lamotrigine clearance 2.5 times greater than in controls. The interaction is further supported by the fact that changes in hormone levels are known to influence the pharmacokinetics of glucuronidated drugs in humans, and elimination of lamotrigine is significantly increased during pregnancy.

Anyway - She's been having serious balance issues, come to think of it, she had a weird rash as well as kept saying she felt some weird hollowness around her head.

I think, these "blood plasma levels" from the lamotrigine was reduced by the birth control pills...I also think that two months later the actual lamotrigine became "toxic" and started producing symptoms of rash/vertigo/headache/tinitus/balance/etc

Thanks for everyone's help on this site... I'm really glad I discovered it!

 

[Krista2882]

Oh my gosh, I understood this the opposite way around for years! I thought my doctor and pharmacist were telling me that my AED's would interfere with the birth control pills, making them ineffective-- not the other way around! I was even on BC for a while because my doctor thought that would help reduce my seizures since they are triggered by hormones. That was before I was on Lamictal, though (I was just on Tegretol and Keppra at the time).

 

[Atmosphere]

Oh my gosh, I understood this the opposite way around for years! I thought my doctor and pharmacist were telling me that my AED's would interfere with the birth control pills, making them ineffective-- not the other way around! I was even on BC for a while because my doctor thought that would help reduce my seizures since they are triggered by hormones. That was before I was on Lamictal, though (I was just on Tegretol and Keppra at the time).

Well this is what we were also told at 3 different pharmacies - however I believe that with Lamotrigine and ethinyl estradiol (found in many different kinds of birth control pills), it seems like it actually reduces lamotrigine.

I'm pretty sure there are other combinations where the AEDs reduces the birth control pills' effectiveness.

I guess it's best to check the interactions like on these websites in this thread. Helped us a bunch!

 

[jonsey]

my daughter seziures occured more around the time of the month . Gp suggested the depo, which she has every 10 weeks. She was on lamactal with the depo . Noticable change, she only seziured if she had a breakthrough. Now on keppra with the depo, reducting lamactal tommorow .

 

[valeriedl]

I was taking depo provara (the shot) so I didn't have a peirod. I didn't have any side effects with that.

I had a hystermacty a few months ago because I know that if I were to get pregnant I would have to stop taking a good bit of my meds and I can't do that. Plus I don't know what side effects that it would have on a baby if I were to have one.

I don't notice any difference in my seizures since I've stoped taking the birth control. I'm not having any more or less and they are the same types that I had before.

 

[Arc2012]

You know what... I expect, as someone who is extremely concerned, that when I ask a pharmacist to check on that, because i'm worried... that at the VERY least he/she tells me: "Yes sir, with this drug combination some patients have issues, others have not. Please monitor closely!"

Definitely not: "Counteract Epilepsy Medication...??? No my dear I think that is an old wives tale, designed to make you not have premarital sex"

or

"No I don't see any problems"

Out of the 10 times I've asked specifically for them to check... not ONCE have they mentioned anything to me. When I asked my GP/Family practitioner, he just said: Pharmacists have a computer system, they check for you - just confirm with them when you get the medicine for alternatives.

If it's happened to us, I'm pretty sure it happens more than once a day!

This is probably the most frustrating part of having epilepsy (for me anyways). It seems as though every doctor wants to point out their specialty to you, however they don't think twice about telling you to ask someone else when they just simply don't want to deal with it.

I am 100% confident that some AEDs and birth controls interact together in very negative ways. But when I ask my neuro, he's says go to your gyn, I'm an epilepsy specialist and have no clue about hormones. When I ask my obgyn, they say no this birth control doesn't cause this side affect, call your neuro. When I went back to my neuro to tell him what the gyn said he told me to contact my GP and have them find a psyciatrist for me because I have depression. OMG, this is exactly why people with epilepsy have trouble controlling it, no one wants to work together and really get to the root of the problem. Our entire body works together to function, why can't these doctors do the same???

 

[Cint]

I am 100% confident that some AEDs and birth controls interact together in very negative ways. But when I ask my neuro, he's says go to your gyn, I'm an epilepsy specialist and have no clue about hormones. When I ask my obgyn, they say no this birth control doesn't cause this side affect, call your neuro. When I went back to my neuro to tell him what the gyn said he told me to contact my GP and have them find a psyciatrist for me because I have depression. OMG, this is exactly why people with epilepsy have trouble controlling it, no one wants to work together and really get to the root of the problem. Our entire body works together to function, why can't these doctors do the same???

:agree: I have issues, also, with my neuro, ob/gyn, endocrinologsit, and others. None want to communicate with the other, yet they all work at the same University. Soooo frustrating. They just check the computer and say the same thing to me if I'm having problems with one medication or other issues. My neuro will say, check with my endo, who may say check with my neuro or my ob/gyn? Why can't they ask each other, especially since they are all in the SAME system?!onder::bigmouth:

Anyway, here is a useful website for women with epilepsy and birth control:
http://www.epilepsy.com/info/women_oral_contraceptv

 

[Arc2012]

Cint, that's an interesting article. I have not had any med levels checked since I started lamictal, was taken off of OCs, and had a progesterone based IUD placed. I might have to show that article to my neuro, considering that's when I started having so many problems again. He just loves it when I do stuff like that

 

[tinathesingergirl]

Yes, there is a coralation between the effectiveness of the pill and the AED Drugs I was told not to go on the pill when I went on my anti-seizure meds. My options were given to me by my doctors I could get an IUD, or I could get Depro-Provera which would only last for 3 months instead of the standard 6 months, I could get my tubes tied(no), or my husband could get a vascectomy (no), I researched the new nueva ring and suggested it to my doctors although it is not in their literature I have not have any complications with my medications and have had no problems and it actually took care of some of my libido issues i was having with one of my meds. 3 weeks in,on the 4th week my period comes like clockwork, the hormones are localized no pills to remember and if there is a complication in the hospital it is easy to remove it is not permanent. Insurance will cover it.

Tina

 

[MaryK]

I was told the same, no birth control pills with seizures and migraines. Although,this was many many years ago and at that time birth control pills were very strong.. I think I was on OrthoNovum, do not remember which number

 

[Atmosphere]

We got back from the Neurologist... She increased my wife's lamotrigine from 200mg every evening to 250mg every evening.

She said that the pill "Biphasil", comes highly recommended to people suffering from Epilepsy - and that our Family GP prescribed the correct one.

She also said that the only real tablets which interfere with lorazepam would be anything with Codeine in it... and that the Biphasil is actually found to be working well with Lamotrigine.


Biphasil details:

--------------------------------------------------------
BIPHASIL* tablets

COMPOSITION:
The eleven white tablets of BIPHASIL* contain 50 µg of levonorgestrel and 50 µg of ethinyl oestradiol.
The ten orange tablets contain 125 µg of levonorgestrel and 50 µg of ethinyl oestradiol.
The seven red tablets are inert.
The orange tablets contain TARTRAZINE.
--------------------------------------------------------

Because women have different kinds of estrogen, progesterone and all sorts of other different levels in their bodies throughout the month, very often a seizure can occur during certain parts of the menstrual cycle. As the neurologist explained, your estrogen levels increase after the "red pills" or the placebo pills, it then reaches a plateau, and then right after you take the last "active pill", then the estrogen drops again.

Our neurologist said that a lot of women have seizures during the estrogen increase or a few days before the estrogen decrease. She further said that most women who has epilepsy linked to their menstrual cycle, have higher chance of getting a seizure right before menstruation.

It was not neccesarily the Biphasil which caused or interfered with the Lamotrigine, however it was probably, and could also probably have been the case with each seizure -- where her epilepsy is linked to the Estrogen levels and the specific time of the month in her cycle.

She has prescribed Lorazepam to my wife to take "as needed", or whenever she feels anxious, or a couple of days before her menstruation starts.

(That stuff is awesome!!! It's basically a tranquilizer!)

She says that you get Lorazepam and Diazepam or Valium... Both of these drugs have anti-convulsive properties, but lorazepam's anti-convulsive properties are a LOT better than Diazepam's.

My wife is also not allowed to drive for 6 months. Not that anyone is checking in South Africa...however if she causes an accident, the other party will make her go to jail if she has been driving within 6 months of her last seizure.