Can a 25-year-old woman with epilepsy use birth control?

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Contraceptive pills make epilepsy (a chronic brain condition that causes repeated seizures) attacks worse. For that, you need to consult a consultant neurologist (brain specialist) for pre-pregnancy counseling and management.

The risks of congenital malformations in the fetuses of pregnant women with epilepsy (WWE) exposed and not exposed to antiepileptic drugs (AEDs) are the following:

1. WWEs who are planning their pregnancy should have a clinician competent in the management of epilepsy take responsibility for sharing decisions around the choice and dose of AEDs, based on the risk to the fetus and control of seizures.

2. WWE should be reassured that most mothers have normal, healthy babies, and the risk of congenital malformations is low if they are not exposed to AEDs in the periconception period.

3. Women should be informed that the risk of congenital abnormalities in the fetus is dependent on the type, number, and dose of AEDs.

There are long-term neurodevelopmental outcomes of exposure to AEDs and maternal seizure in infants born to WWE. WWE and its partners need to be informed about the possible adverse impact on the long-term neurodevelopment of the newborn following in utero exposure to sodium valproate.

Based on limited evidence, in utero exposure to Carbamazepine and Lamotrigine does not appear to adversely affect the neurodevelopment of the offspring. There is very little evidence for Levetiracetam and Phenytoin. Parents should be informed that evidence on long-term outcomes is based on small numbers of children.

All WWE should be advised to take 5 mg/day of Folic acid prior to conception and to continue the intake until at least the end of the first trimester to reduce the incidence of major congenital malformation.

Prepregnancy Folic acid 5 mg/day may help reduce the risk of AED-related cognitive deficits.

The lowest effective dose of the most appropriate AED should be used.

Exposure to sodium valproate and other AED polytherapy should be minimized by changing the medication prior to conception, as recommended by an epilepsy specialist after a careful evaluation of the potential risks and benefits.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.