Does your mood stabilizer interfere with birth control?

If you are taking mood stabilizers for bipolar disorder, you need to know which drugs interact, and will these drugs reduce your birth control effectiveness?


Anticonvulsants (antiepileptic drugs) are commonly used in people with bipolar disorder and are one of several classes of drugs that are considered mood stabilizers (along with lithium and certain antipsychotics). Although these drugs are designed to control epilepsy, they are usually very effective in stabilizing mood, so they are called mood stabilizers.

Although these drugs may be very effective, there are some important drug interactions that you need to be aware of, which may increase your chances of pregnancy and may also increase your risk of pregnancy during pregnancy.

Interaction type

Mood stabilizers can interact with hormonal contraceptive methods (such as birth control pills) in several different ways. Remember, there are several different types of hormonal contraceptives, of which contraceptives are just one. Some possible pregnancy prevention and related interactions include:

  • Contraceptives related to mood stabilizers are less effective
  • People taking birth control pills are less effective with mood stabilizers
  • Increased levels and side effects of biphasic drugs in people who use birth control pills
  • If you are pregnant, the possibility of drug-related birth defects
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Let’s take a look at some specific mood stabilizers and how they interact with birth control (or pregnancy).

Ticagrelol (carbamazepine)

Tegretol (carbamazepine) is known for causing contraceptive failure in people who use birth control pills (oral contraceptives).In addition, for those who become pregnant while taking Tegretol, there is an increased risk of fetal birth defects.

Women taking Tegretol should be instructed to use condoms and other auxiliary contraceptive methods.

In some cases, the gynecologist may also recommend higher doses of birth control pills.

Trileptal (oxcarbazepine)

Trileptal (oxcarbazepine) may also interfere with birth control pills. Contraceptive pills containing estrogen and progesterone, contraceptive pills containing only progesterone (mini pills), contraceptive progesterone injections (such as Depo-Provera), progesterone in the form of contraceptive implants (such as Nexplanon), and progesterone-containing uterus Internal IUDs (eg because of Mirena IUD and Skyla IUD) may not work properly if you take them while taking oxcarbazepine.

Topamax (Topiramate)

Topamax (topiramate) has a risk of reducing the effectiveness of contraception, and people who become pregnant while taking the drug have a great risk of birth defects, such as cleft lip and palate.

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Lamictal (Lamotrigine)

For another anticonvulsant, Lamictal (Lamotrigine), some contraceptives can increase its metabolism and affect the effect of mood stabilizers.On the other hand, higher doses of Lamictal will reduce the effectiveness of certain birth control measures.

If you start taking lamotrigine, be sure to tell your doctor if you are taking birth control pills; if you are already taking Lamictal, if you start or stop taking birth control pills, please tell your doctor immediately.

Be your own champion

We have listed some potential drug interactions between commonly used biphasic drugs (mood stabilizers) and birth control drugs, but no more interactions are listed here.

It is important to understand the medicines you are using, especially if you get these medicines from different suppliers, there may be interactions. Pharmacists often find interactions, but you cannot assume that this will happen. 50% of people who take five or more drugs daily will experience adverse drug interactions.

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A 2016 study found that although many doctors are aware of the possible drug interactions between anticonvulsants and contraceptives, they are not very familiar with the adverse reactions and interactions associated with specific drugs.

How to avoid drug interactions

  • Please take all medicines (in the original bottle) with you every time you visit a doctor.
  • Keep in mind that over-the-counter medicines and nutritional supplements may also interact with certain medications, and your doctor should be aware of any herbal treatments or vitamin supplements you are taking.
  • Make sure all your providers understand all the medicines you are using, not just the medicines they prescribe.

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Bottom line? If you are taking or want to take birth control pills, always Make sure that the doctor who prescribes your biphasic medicine knows this, and that the doctor who prescribes the contraceptive pill knows about your biphasic medicine. It is also worthwhile to discuss possible drug interactions with your pharmacist.