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While final answers are still years away, preliminary evidence suggests that giving progesterone during menstruation may help to assuage hormone-related seizures.But not all the news is good: Other studies have shown that some older epilepsy drugs, particularly valproate (sold under the brand names Depakote, Depakene, and Epivil), can interfere with ovulation, Pack tells Web MD.Valproate and Felbatol, on the other hand, can actually raise hormonal levels, which may require an adjustment in dose.Like Lamictal, Neurontin has no effect on hormonal balance and thus does not interfere with the effectiveness of birth control pills.
According to Pack, the female hormones estrogen and progesterone act on certain parts of the brain where partial seizures often begin.
That's not to say that valproate is not a good drug, but with so many other choices available, [for these women] I tend to pick something that won't have these side effects." While a variety of factors need to be considered when choosing a medication to control seizures in women with epilepsy, Pack says many neurologists have indicated a preference for Lamictal due to its relatively safe side-effect profile.
According to the Epilepsy Foundation, Lamictal neither increases the breakdown of female hormones nor interferes with the effectiveness of hormonal birth control, unlike other seizure medications.
But for women with epilepsy who also suffer from migraine headaches, Topamax is usually considered the drug of choice because of its headache-relieving properties, Pack says.
Given the complex interactions between hormones and seizures, it's not surprising that certain seizure medications can prevent birth control pills from working effectively, experts note.