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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Ambrosia on May 20, 2001, at 15:52:45
Any women out there have experience with taking Ortho-Tri-Cyclan with meds like Prozac, Wellbutrin, Klonopin, and Trazadone (those are the meds I take.) Did anyone else have negative side effects while taking birth control pills with antidepressants, and if so did they go away? I feel tired, headachy, and ill most of the time since I started taking the birth control pills, and I feel like just throwing them away. Besides I heard my psychiatric meds make the birth control way less effective.
> > >Ambrosia
Posted by AnneL on May 20, 2001, at 17:18:32
In reply to The Pill and Psychiatric Meds, posted by Ambrosia on May 20, 2001, at 15:52:45
> Ambrosia,
I have not read that psychotropic medications interfere with the efficacy of oral contraceptives such as Ortho-Triclyclen, however,
headaches, nausea and fatigue are all common side effects of birth control pills. Nausea and fatigue should disappear by the end of your third cycle of pills, however, headache is something you should discuss with your gynecologist. Some women are very sensitive to the progesterone component of the pill and respond with very severe headaches. You may be able to take the pill successfully without headaches by changing your brand of pill. Some women cannot tolerate the birth control pill at all, causing very serious headaches which may represent an increased risk of stroke (very small risk, however, headache must always be reported to your physician). Other women become profoundly depressed while taking any type of hormonal contraceptive, whether it be a combination oral contraceptive or something like depo-provera (the every 3 month "shot"). The long and the short of it is this: nausea and fatigue are common and not serious side effects that usually subside within 3 months, headaches must be reported to your physician. If contraception is a consideration and you decide hormonal preparations are not for you, there are of course other options which are very effective. Talk to your doctor. Good Luck, Anne
Posted by Sunnely on May 20, 2001, at 22:09:18
In reply to The Pill and Psychiatric Meds, posted by Ambrosia on May 20, 2001, at 15:52:45
None of the medications you are taking lessens the effectiveness of the birth control pills (as a contraceptive). However, fluoxetine (Prozac) may interfere with the metabolism of the birth control pills through inhibition of the liver enzyme CYP3A4. This action can decrease the clearance of the birth control pills from the body and prolong its estrogen-related side effects such as migraine headaches and thromboembolic events (increased risk for stroke or pulmonary embolism). Other known drugs to increase the estrogenic effects of birth control pills include the antifungals ketoconazole (Nizoral), itraconazole (Sporanox), and fluconazole (Diflucan); antivirals such as ritonavir (Norvir); certain antibiotics such as erythromycin, azithromycin (Zithromax) and clarithromycin (Biaxin); the antidepressant nefazodone (Serzone). Even grapefruit juice is known to increase estrogen levels. Estrogenic effects also increase when vitamin C or acetaminophen (Tylenol) is added. This interaction between vitamin C or acetaminophen and birth control pills is via a different pathway.
On the other hand, drugs that hasten the action of this liver enzyme (CYP3A4) may lead to increased clearance of the birth control pills from the body and loss of its effectiveness (contraceptive effect). These drug interactions may result in spotting, breakthrough bleeding, or unwanted pregnancy. Drugs that induce CYP3A4 and can cause contraceptive failure include carbamazepine (Tegretol), felbamate (Felbatol), griseofulvin (Fulvicin), oxcarbazepine (Trileptal), phenobarbital (Luminal, Barbita), phenytoin (Dilantin), primidone (Mysoline), rifampin (Rifadin), ritonavir (Norvir), topiramate (Topamax), and troglitazone (Rezulin). St. John's wort has recently been shown to induce CYP3A4, and the herbal preparation is likely to cause contraceptive failure, although formal case reports have not yet entered the literature. Some anticonvulsants/mood stabilizers such as valproate (Depakene, Depakote), gabapentin (Neurontin), lamotrigine (Lamictal), and vigabtrin (Sabril) have been shown NOT to increase birth control clearance.
Do not stop your birth control pills without consulting with your doctor.
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> Any women out there have experience with taking Ortho-Tri-Cyclan with meds like Prozac, Wellbutrin, Klonopin, and Trazadone (those are the meds I take.) Did anyone else have negative side effects while taking birth control pills with antidepressants, and if so did they go away? I feel tired, headachy, and ill most of the time since I started taking the birth control pills, and I feel like just throwing them away. Besides I heard my psychiatric meds make the birth control way less effective.
> > > >Ambrosia
Posted by loosmrbls on May 21, 2001, at 8:59:24
In reply to The Pill and Psychiatric Meds, posted by Ambrosia on May 20, 2001, at 15:52:45
My wife always had PMS (now PMDD, I guess).
When she tried hormonal contraceptives -- both the pill and depo-provera -- she became EXTREMELY moody. This is not a knock on women in any way, I mean it sincerely. It was like "wow!". Any sort of arguement, and she flew off the handle -- once threw a cell phone against a wall then out a window.
Some women cannot tolerate hormonal contraceptives, and it is clear that hormones -- sex and stress hormones -- play a role in depression. Remember, women are much more likely to get depressed than men (like a 2:1 ratio).
This is the end of the thread.
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