Overview
Anticonvulsants (antiepileptic) drugs are commonly used for people with bipolar disorder and are one of several classes of medications considered to be mood stabilizers (along with lithium and certain antipsychotics). While these drugs were devised for controlling seizures, they are often very effective in stabilizing mood and have been called mood stabilizers for this reason.
Types of Interactions
There are several different ways in which mood stabilizers can interact with hormonal methods of birth control such as birth control pills. Keep in mind that there are several different types of hormonal birth control, of which birth control pills are only one type. Some possible pregnancy prevention and related interactions include:
Decreased effectiveness of birth control pills related to the mood stabilizerDecreased effectiveness of the mood stabilizer among those who take birth control pillsIncreased levels and side effects of the bipolar drug in those who used birth control pillsPotential for birth defects related to the drug if you become pregnant
Let’s look at a few of the specific mood stabilizers and how they may interact with birth control (or pregnancy.)
Tegretol (Carbamazepine)
Tegretol (carbamazepine) is especially known for causing contraceptive failures among those using birth control pills (oral contraceptives). In addition, for those who do become pregnant while taking Tegretol there is an increased risk of birth defects in the fetus. In some cases, a gynecologist may recommend using a higher dosage of birth control medications as well.
Trileptal (Oxcarbazepine)
Trileptal (oxcarbazepine) may also interfere with contraceptives. Birth control pills containing estrogen and progestin, progestin-only birth control pills (the mini pill), contraceptive progestin injections (such as Depo-Provera), contraceptive implant forms of progestin (such as Nexplanon), and progestin-containing IUDs, (such as the Mirena IUD and the Skyla IUD) may not work properly if you take them while you are taking oxcarbazepine.
Topamax (Topiramate)
Topamax (topiramate) has a risk of decreased contraceptive efficiency as well as carrying a strong risk of birth defects such as cleft lip and palate in those who become pregnant while taking the medication.
Lamictal (Lamotrigine)
In the case of another anticonvulsant, Lamictal (lamotrigine), some birth control can increase its metabolism and affect how well the mood stabilizer works. In the other direction, higher doses of Lamictal can decrease the effectiveness of certain birth control. If you are starting to take lamotrigine, make sure to tell your doctor if you are taking birth control medication; if you are already taking Lamictal, tell your doctor right away if you start—or stop—taking birth control.
Be Your Own Advocate
We have listed a few of the potential drug interactions between commonly used bipolar medications (mood stabilizers) and birth control medications but there are many more interactions not listed here. It’s important to understand that the medications you are using, particularly if you are getting these medications from different providers, have the potential to interact. Pharmacists frequently find interactions, but you can not assume this will occur. Fifty percent of people taking five or more medications daily experience an adverse drug interaction.
How to Avoid Drug Interactions
Bring all of your medications with you, in their original bottles, to each office visit.Keep in mind that over-the-counter medications and nutritional supplements may also interact with some drugs and your doctors should be aware of any herbal treatments or vitamin supplements you are taking.Make sure that all of your providers are aware of all of the medications you are using, not just the drugs they are prescribing.
A Word From Verywell
The bottom line? If you are taking or want to take contraceptives, always make sure the doctor who prescribes your bipolar medications knows about it, and that the doctor prescribing the contraceptive knows about your bipolar medications. It’s also worthwhile to talk to your pharmacist about possible drug interactions as well.
