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Epilepsy in WomenAka: Contraception Selection in Seizure Disorder, Antiepileptic Drug Interactions in Contraception, Catamenial Seizure
- See Also
- Contraception
- Oral Contraceptive Drug Interaction
- Epilepsy in Pregnancy
- Seizure
- Single Seizure Evaluation
- Status Epilepticus
- Associated Conditions in Women with Epilepsy
- Catamenial Seizure
- Occurs in up to 50% of women with Epilepsy
- Seizure related to Menstrual Cycle
- Onset of Menses due to Progesterone withdrawal
- Mid-cycle at Ovulation due to Estrogen surge
- Polycystic Ovary Disease
- Occurs in up to 40% of women with Epilepsy
- Subset related to Valproate
- Improves with medication change
- Contraceptive Selection in Epilepsy
- Consider non-Hormonal Contraception
- Avoid OCP with antiepileptics that induce CYP P450
- These agents listed below render OCPs less effective
- OCP failure rate with these agents >6%
- Norplant also less effective with these agents
- Use 50 ug Estrogen pill if OCP used for Contraception
- Oral Contraceptives (OCP)
- Antiepileptics that induce P450 system (avoid with OCP)
- Carbamazepine (Tegretol)
- Ethosuximide (Zarontin)
- Felbamate
- Phenobarbital
- Phenytoin (Dilantin)
- Primidone (Mysoline)
- Oxcarbazepine (Trileptal)
- Topiramate (Topamax)
- Antiepileptics that do not affect OCP efficacy
- Gabapentin (Neurontin)
- Levetiracetam (Keppra)
- Lamotrigine (Lamictal)
- Tiagabine (Gabitril)
- Valproate (Depakote)
- Zonisamide (Zonegran)
- References
- Morrell (2002) Am Fam Physician 66(8):1489
- Zahn (1998) Neurology 51:949
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