It is advisable that women taking medications practice birth control to avoid the risks of unplanned pregnancy and potential harm to the fetus through early exposure to medications. A slightly increased risk of serious malformations has been reported with lithium (Ebstein’s anomaly, a cardiac malformation) and especially with the anticonvulsants valproate (Depakote) and carbamazepine (Tegretol) (neural tube defects in the developing nervous system, including spina bifida and facial abnormalities).
Additionally, the choice of birth control will need to be influenced by the medications being used. The anticonvulsants carbamazepine (Tegretol), oxcarbazepine (Trileptal), and topirimate (Topamax) all increase the breakdown of oral contraceptives (birth control pills), rendering them less effective or ineffective. Women on these medications should use an alternative form of birth control, such as an intrauterine device (IUD) or higher doses of combined oral contraceptives, such as the older ones.