Contraceptive to be avoided in epilepsy:

. Ans. a. OCPs (Ref: Leon Speroff 8/e p1026]Contraceptive to be avoided in epilepsy is OCPs."Epilepsy/seizure disorder is a relative contraindication for the use of OCPs as antiepileptic drugs like phenytoin, carbamazepine and phenobarbitone induce the synthesis of liver enzyme thereby reducing the plasma levels of ethinyl estradiol in women on combined pills, thereby increasing the chances of contraceptive failure.""In epilepsy, consideration should be given to methods that neither affect antiepileptic drug metabolism nor the methods affected by drugs. These include intrauterine contraception with copper IVD, or levonorgestrel releasing IVD, long actingprogestins only, barrier methods and sterilization. Leon Speroff 8/epi026Adverse effects of Oral contraceptive pills* Nausea, vomiting, headache (migraine may be worsened)* Breakthrough bleeding or spotting, amenorrhoea* Breast discomfort (Mastalgia)* Weight gain, acne and increased body hair* Chloasma, pruritus vulvae* Carbohydrate intolerance* Mood swings, abdominal distention* Leg vein and pulmonary thrombosis0* Coronary and cerebral thrombosis - Ml, stroke.- Estrogen component is responsible for venous thromboembolism.- Both estrogen and progesterone are responsible for arterial phenomenon.* Rise in BPdeg* increased risk of cervical carcinoma0 (risk of endometrial and ovarian carcinoma is decreased)* Gall stones, benign hepatoma(r)* Estrogen increases the risk of endometrial cancer.* Progesterone component decreases this risk in OCPs.* Estrogen has favorable effect on lipid profile while progesterone has opposite effect.* Progesterone component is mainly responsible for MI.