Depo-Provera and Lamotrigine for epilepsy

[McPom]

Hiya,

I just wondered if anyone had any advice on this, please. I'm going to have the depo injection tomorrow and I've got epilepsy though I haven't had a seizure in a decade. I'm on 200mg of lamotrigine for the epilepsy. I've been looking up the interactions between the depo and lamotrigine and I'm really undecided as to whether to have the jab or not.

It seems like the hormones in the injection, in some cases, make the liver less effective in breaking down the lamotrigine and visa versa. But, other sites say the depo doesn't make any difference to the lamotrigine. Some websites advise you to just have the depo every 10 weeks instead of every 12 weeks and that sorts out the effectiveness of the contraception. But what about how well the epilepsy medication works?

I'd like to have the depo, but at the same time I really don't want to have a seizure. I'm thinking at the end of the day it will just be a judgement call, do I want to risk it or not.

Does anyone have any up-to-date info or helpful advice on the interaction between the two drugs? I'm in a real muddle.

Thanks very much.

[MiniJellyBeans]

Hi McPom, only just seen this so probably too late to be of any use, but I work in family planning and can reassure you that the up to date guidance is that Depo Provera is not affected by lamotrigine or any other liver enzyme-inducing medication, so there is no need to have the injection more frequently and no reason why your seizure control should worsen. I can go into the reasons why if you like but don't want to bore you rigid! Incidentally, most other hormonal methods (pills, patches, implant etc) are affected by enzyme-inducing meds, but lamotrigine is a weak enzyme inducer and doses up to 200mg/day are not thought to have a significant effect.

[MiniJellyBeans]

D'oh....sorry McPom, ignore that very last bit about 200mg/day - I was thinking of another antiepileptic, topiramate Lamotrigine is not thought to be an enzyme inducer at any dose.

However, just to reassure you about the issue of Depo worsening your seizure control by reducing lamotrigine levels - this only applies to oestrogen-containing contraceptives (such as the combined pill or patch), there is no known effect from progestogen-only methods like Depo.

[McPom]

Hi MiniJellyBeans,

Thank you so much for the really useful information.

It's great to get a definitive answer to this one. There's a lot of conflicting information on the net about depo and epilepsy. I did have the depo and it did not impact on my epilepsy. Hopefully, other women with epilepsy thinking of using this birth control will find your post.