Despite the fact that hormonal contraceptives interact with certain antiepileptic drugs, a recent study has shown that only 35% of 397 female patients with epilepsy were given any clinician counseling about contraceptive choices during their first clinic visit. And these patients were unlikely to receive contraceptive counseling during subsequent visits. The implications of these findings are troubling: Many antiepileptic agents decrease the efficacy of hormonal contraceptives by inducing hepatic enzymes, and estrogen-containing contraceptives are known to accelerate the metabolism of lamotrigine, an antiepileptic drug commonly prescribed in women of child-bearing age. Espinera et al also found that when women with epilepsy are given advice about the advantages of IUDs, they are far more likely to switch to IUDs, which are highly effective without AED drug interactions.
Espinera AR, Gavvala J, Bellinski I, et al. Counseling by epileptologists affects contraceptive choices of women with epilepsy. Epilepsy Behav . 2016;65:1-6.