Any birth control that is safe for women, in general, is safe for women with epilepsy. However, having epilepsy -- and some treatments for the condition -- can make some forms of birth control less effective. Also, because anti-seizure medications for epilepsy can increase the risk of birth defects, it's important to plan pregnancy carefully.
Fifty percent of all patients with newly diagnosed epilepsy will become seizure-free with the first epilepsy drug they try. For the rest, it's try, try again: switching epilepsy medications, adjusting to side effects, and waiting to make sure the new drug works. Others find their seizures are controlled, but they can't tolerate the medication's side effects and need to switch drugs.
Before you ask your doctor if your medication should be switched, make sure you are taking your current medication...
If you have epilepsy and take anti-seizure drugs, your birth control options could include hormones such as birth control pills or Depo-Provera injections, barrier methods like condoms or a diaphragm, or an intrauterine device (IUD). Natural family planning such as the rhythm method -- abstaining on your fertile days -- can also be used, although this method may not be as reliable as others. All of these methods are safe for you.
If you are taking anti-seizure medications, some of these drugs can interact with some hormonal types of birth control and make them less effective. If you understand these interactions, most of the time you can use the pill and other kinds of hormonal birth control effectively.
Different types of anti-seizure medications interact with hormonal birth control in different ways:
One group of anti-seizure drugs is known as "liver enzyme-inducing" drugs. They increase the rate at which the liver breaks down the contraceptive hormones that you get from birth control. This means that the contraception medication will leave your body faster. Liver enzyme-inducing drugs include carbamazepine (Tegretol, Carbatrol), oxcarbazepine (Trileptal), phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline), eslicarbazepine acetate (Aptiom), and topiramate (Topamax). If you are taking one of these drugs, it can make your hormonal birth control less effective.
Two drugs -- valproate (Depakote) and felbamate (Felbatol) -- can even increase hormonal levels. If you are on one of these drugs, your doctor may need to adjust the dosage of your birth control so that you don't have too much of the contraceptive in your body.
Finally, there are "neutral" drugs which don't have any effect on hormone breakdown. Gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), clobazam, clonazepam, ethosuximide, Lyrica, sodium valproate, Zonegran, and tiagabine (Gabitril) will not interfere with your birth control.