Q:  Birth Control Pills & Mood Stabilizers

 I was diagnosed as bipolar II or mood disorder-NOS this summer after years of only having been treated for depression. I am on Trileptal and Wellbutrin SR. Because of Trileptal, I am no longer using oral or hormonal birth control. I have tried other birth control methods, condoms (I become full of anxiety until my period.) and the IUD (which didn't work out for me).

I am trying to find a mood stabalizer that I can use oral birth control, without losing any effectiveness. Or one doctor mention using Yasmin since the dose is higher at 50 micograms. 

Any information that you can provide will be greatly appreciated.

Dear Jo -- 
If you're getting a good response to Trileptal, it might be worth a hunt for an alternative contraceptive, as the alternatives that do not interfere with BCP effectiveness (e.g. lithium, valproate, olanzapine) all have weight gain as a side effect risk.  Lamotrigine is another alternative but it's quite a different medication from Trileptal (whereas the others above have somewhat more similar patterns of action and response, at least valproate and probably olanzapine).  

Now you're supposed to be able to just turn up the BCP dose to make up for the slight decrease in estrogen and progesterone that Trileptal can cause; so in that respect the Yasmin (also a BCP) represents a standard solution; but your ob-gyn or primary care doc' must be able to affirm for you that the BCP is working for contraception before you rely on it.  Until then, it's condoms or some other means, right?

Dr. Phelps


Published March, 2004