Can Your Mood Stabilizer Interfere With Birth Control?

Table of ContentsView AllTable of ContentsOverview of Mood StabilizersPotential InteractionsBe Your Own AdvocateHow to Avoid Drug Interactions

Table of ContentsView All

View All

Table of Contents

Overview of Mood Stabilizers

Potential Interactions

Be Your Own Advocate

How to Avoid Drug Interactions

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Mood stabilizers are psychiatric medications that are prescribed to treat mental health conditions such asbipolar disorder, depression,borderline personality disorder, andschizoaffective disorder. Some types of mood stabilizers can interact with oral contraceptives, which may affect the effectiveness of either or both medications.

If you are taking a mood stabilizer, it is important to talk to your doctor about how it might affect your birth control method to avoid unintended pregnancy or other drug interactions. It is also important to consider whether hormonal birth control might make your mood stabilizer less effective.

At a GlanceMood stabilizers can be an effective treatment for some mental health conditions, but they can also interact with other medications you might be taking, including oral contraceptives. Being aware of these effects is important to avoid unwanted side effects and potential interactions that might make your medications less effective at treating your condition and preventing pregnancy. Keep reading to learn more about what you need to know about drug interactions and whether these medications make your birth control less effective.

At a Glance

Mood stabilizers can be an effective treatment for some mental health conditions, but they can also interact with other medications you might be taking, including oral contraceptives. Being aware of these effects is important to avoid unwanted side effects and potential interactions that might make your medications less effective at treating your condition and preventing pregnancy. Keep reading to learn more about what you need to know about drug interactions and whether these medications make your birth control less effective.

Anticonvulsants (antiepileptic) drugsare commonly used for people with bipolar disorder and are one of several classes of medications considered to bemood stabilizers(along with lithium and certain antipsychotics). While these drugs were devised for controlling seizures, they are often veryeffective in stabilizing moodand have been called mood stabilizers for this reason.

While these medications can be very effective, there are important drug interactions you will need to be aware of that could both increase the chances you get pregnant as well as increase the pregnancy risks if you were to become pregnant.

Interactions Between Mood Stabilizers and Hormonal Birth Control

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:

Let’s look at a few of the specific mood stabilizers and how they may interact with birth control (or pregnancy.)

Types of Medication for BPD

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.

Women who are prescribed Tegretol should be instructed to use secondary methods of birth control such as condoms.

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 that may not work properly if you take them while you are taking oxcarbazepine include those:

Topamax (Topiramate)

Topamax(topiramate) has a risk of decreased contraceptive efficiency. However, some research suggests that taking low-dose topiramate with oral contraceptives may not increase the risk of unintended pregnancy.

Topiramate also carries a big risk of birth defects, such as cleft lip and palate, in those who become pregnant while taking the medication.

Lamictal (Lamotrigine)

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.

The Impact of Bipolar Disorder on Sex

Be aware that your healthcare provider may not know every interaction between every specific medication off the top of their head. You should make sure they know all the medications, supplements, and substances you are taking and check for specific interactions before prescribing any medication.

A 2016 study found that while many physicians are aware that there can be drug interactions between anticonvulsants and birth control, they were less familiar with the adverse effects and interactions related to specific drugs.

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. Evidence suggests that 50% of people taking five or more medications daily experience an adverse drug interaction.

There are strategies that can help you minimize the risk of experiencing drug interactions between your mood stabilizers and oral contraceptives (as well as other medications):

Make sure that all of your providers are aware ofALLof the medications you are using, not just the drugs they are prescribing.

Keep in Mind

The bottom line is that if you are taking or want to take contraceptives,alwaysmake 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.

Are Antidepressants Safe in Pregnancy?

7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Williams, D.Antiepileptic Drugs and Contraception.US Pharmacist. 2014. 39(1):39-42.Sarayani A, Brown JD, Goodin AJ, et al.A pharmacoepidemiologic approach to evaluate real-world effectiveness of hormonal contraceptives in the presence of drug-drug interactions.Epidemiology. 2021;32(2):268-276. doi:10.1097/EDE.0000000000001302Sarayani A, Winterstein A, Cristofoletti R, Vozmediano V, Schmidt S, Brown J.Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes.Contraception. 2023;120:109953. doi:10.1016/j.contraception.2023.109953Hernandez-Diaz S, Huybrechts KF, Desai RJ, et al.Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study.Neurology. 2018;90(4):e342-e351. doi:10.1212/WNL.0000000000004857Rauchenzauner M, Deichmann S, Pittschieler S, et al.Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy - Role of progestins.Seizure. 2020;74:89-92. doi:10.1016/j.seizure.2019.11.011Suto HS, Braga GC, Scarpellini GR, et al.Neurologist knowledge about interactions between antiepileptic drugs and contraceptive methods.Intl J Gynecology & Obste. 2016;134(3):264-267. doi:10.1016/j.ijgo.2016.03.015Maher RL, Hanlon J, Hajjar ER.Clinical Consequences of Polypharmacy in Elderly.Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338.2013.827660

7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Williams, D.Antiepileptic Drugs and Contraception.US Pharmacist. 2014. 39(1):39-42.Sarayani A, Brown JD, Goodin AJ, et al.A pharmacoepidemiologic approach to evaluate real-world effectiveness of hormonal contraceptives in the presence of drug-drug interactions.Epidemiology. 2021;32(2):268-276. doi:10.1097/EDE.0000000000001302Sarayani A, Winterstein A, Cristofoletti R, Vozmediano V, Schmidt S, Brown J.Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes.Contraception. 2023;120:109953. doi:10.1016/j.contraception.2023.109953Hernandez-Diaz S, Huybrechts KF, Desai RJ, et al.Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study.Neurology. 2018;90(4):e342-e351. doi:10.1212/WNL.0000000000004857Rauchenzauner M, Deichmann S, Pittschieler S, et al.Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy - Role of progestins.Seizure. 2020;74:89-92. doi:10.1016/j.seizure.2019.11.011Suto HS, Braga GC, Scarpellini GR, et al.Neurologist knowledge about interactions between antiepileptic drugs and contraceptive methods.Intl J Gynecology & Obste. 2016;134(3):264-267. doi:10.1016/j.ijgo.2016.03.015Maher RL, Hanlon J, Hajjar ER.Clinical Consequences of Polypharmacy in Elderly.Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338.2013.827660

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Williams, D.Antiepileptic Drugs and Contraception.US Pharmacist. 2014. 39(1):39-42.Sarayani A, Brown JD, Goodin AJ, et al.A pharmacoepidemiologic approach to evaluate real-world effectiveness of hormonal contraceptives in the presence of drug-drug interactions.Epidemiology. 2021;32(2):268-276. doi:10.1097/EDE.0000000000001302Sarayani A, Winterstein A, Cristofoletti R, Vozmediano V, Schmidt S, Brown J.Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes.Contraception. 2023;120:109953. doi:10.1016/j.contraception.2023.109953Hernandez-Diaz S, Huybrechts KF, Desai RJ, et al.Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study.Neurology. 2018;90(4):e342-e351. doi:10.1212/WNL.0000000000004857Rauchenzauner M, Deichmann S, Pittschieler S, et al.Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy - Role of progestins.Seizure. 2020;74:89-92. doi:10.1016/j.seizure.2019.11.011Suto HS, Braga GC, Scarpellini GR, et al.Neurologist knowledge about interactions between antiepileptic drugs and contraceptive methods.Intl J Gynecology & Obste. 2016;134(3):264-267. doi:10.1016/j.ijgo.2016.03.015Maher RL, Hanlon J, Hajjar ER.Clinical Consequences of Polypharmacy in Elderly.Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338.2013.827660

Williams, D.Antiepileptic Drugs and Contraception.US Pharmacist. 2014. 39(1):39-42.

Sarayani A, Brown JD, Goodin AJ, et al.A pharmacoepidemiologic approach to evaluate real-world effectiveness of hormonal contraceptives in the presence of drug-drug interactions.Epidemiology. 2021;32(2):268-276. doi:10.1097/EDE.0000000000001302

Sarayani A, Winterstein A, Cristofoletti R, Vozmediano V, Schmidt S, Brown J.Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes.Contraception. 2023;120:109953. doi:10.1016/j.contraception.2023.109953

Hernandez-Diaz S, Huybrechts KF, Desai RJ, et al.Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study.Neurology. 2018;90(4):e342-e351. doi:10.1212/WNL.0000000000004857

Rauchenzauner M, Deichmann S, Pittschieler S, et al.Bidirectional interaction between oral contraception and lamotrigine in women with epilepsy - Role of progestins.Seizure. 2020;74:89-92. doi:10.1016/j.seizure.2019.11.011

Suto HS, Braga GC, Scarpellini GR, et al.Neurologist knowledge about interactions between antiepileptic drugs and contraceptive methods.Intl J Gynecology & Obste. 2016;134(3):264-267. doi:10.1016/j.ijgo.2016.03.015

Maher RL, Hanlon J, Hajjar ER.Clinical Consequences of Polypharmacy in Elderly.Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338.2013.827660

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