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I wasn't aware that there were any interactions with APs.  I know there are with anti-convulsants, but no one ever said anything about APs and its not printed on the bottle, "This medication may interfere with oral contraceptive."  Hmm. 

Wow, I'm so unhelpful.  I hope somebody responds so I don't have to look this up on my own.

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Is it safe to take birth control pills with antipsychotics?

What do women do for birth control?

Where can I find information on this topic?

Better yet, what do other women do?  What is safe?



There were no interactions reported between atypical or typical antipsychotics available in America and estradiol alone; moderate interaction between clozapine and levonorgestrel in estradiol-levonorgestrel:

MONITOR: Limited data suggest that coadministration with contraceptive hormones may increase the plasma concentrations of clozapine. The exact mechanism of interaction is unknown but may involve inhibition of clozapine metabolism via CYP450 1A2, 2C19 and/or 3A4. A case report describes a 47-year-old woman with refractory paranoid schizophrenia who experienced drowsiness, weakness, and dizziness in association with elevated clozapine plasma levels (736, 770, and 792 ng/mL) during the first 2 months of clozapine therapy while she was also receiving long-term ethinyl estradiol-norethindrone (0.035 mg-0.5 mg) contraception. When the oral contraceptive was discontinued, the patient reported resolution of the clozapine side effects within days. A clozapine level obtained 1 week after contraceptive discontinuation was 401 ng/mL, and two subsequent blood levels over the next 6 weeks showed stable levels of 378 and 389 ng/mL. Although the patient was a heavy smoker, which may have affected the pharmacokinetics of clozapine, no change in her smoking habit was observed during this period. MANAGEMENT: Patients treated concomitantly with hormonal contraceptives may require a lower dosage of clozapine to control psychotic symptoms. Pharmacologic response to clozapine should be monitored more closely whenever an oral contraceptive is added to or withdrawn from therapy in patients stabilized on their existing antipsychotic regimen, and the clozapine dosage adjusted as necessary.
Grapefruit and medroxyprogesterone don't mix, and neither do clozapine and medroxyprogesterone nor clozapine and norethindrone nor clozapine and norgestimate nor clozapine and ethinyl estradiol; basically, clozapine does not mix with hormonal birth control. chlorpromazine plus ethinyl estradiol does this:

Moderate Drug-Drug Interaction:  chlorproMAZINE (chlorproMAZINE) and norgestimate-ethinyl estradiol (ethinyl estradiol-norgestimate)

* The interaction is due to ethinyl estradiol which is a component of ethinyl estradiol-norgestimate

MONITOR: High chlorpromazine plasma concentrations and toxicity have been reported during concomitant use of an oral contraceptive. Chlorpromazine levels increased six-fold (from 134 ng/mL to 838 ng/mL) approximately one week after a patient started taking an ethinyl estradiol-norgestrel combination contraceptive, and she experienced tremors and severe dyskinesias. The mechanism is unknown but inhibition of CYP450 metabolism or effects on P-glycoprotein transport by contraceptive hormones have been suggested. Causality was not clearly determined. MANAGEMENT: Until more information is available, monitoring for signs and symptoms of chlorpromazine toxicity when oral contraceptives are added to the regimen is recommended. Patients should be advised to notify their physician if they experience symptoms such as tremor, dyskinesias, or excessive sedation.

And estradiol and the amitriptyline in perphenazine-amitriptyline DO NOT MIX:

The effects of tricyclic antidepressants (TCAs) may be altered in women receiving estrogen-containing therapy. Simultaneous TCA toxicity and reduced effects have been reported. Akathisia has also been reported in some women taking this combination. The mechanism of interaction is unknown but may be related to increased TCA bioavailability or inhibition of hepatic TCA metabolism. The clinical significance of this interaction has not been established. Monitoring for altered effects may be advisable during concomitant therapy. Dose adjustments of the TCA may be required if an interaction is suspected.

Here's a list of the antipsychotics that AIDSmeds has in its database:

  1. chlorpromazine
  2. haloperidol
  3. prochlorperazine
  4. thioridazine
  5. fluphenazine
  6. mesoridazine
  7. trifluoperazine
  8. perphenazine
  9. perphenazine-amitriptyline
  10. triflupromazine
  11. loxapine
  12. molindone
  13. thiothixene
  14. pimozide
  15. olanzapine
  16. olanzapine-fluoxetine
  17. quetiapine
  18. risperidone
  19. ziprasidone
  20. clozapine
  21. aripiprazole
And here is a list of brands of birth control from MedlinePlus (just press "end" and arrow up until you see them all) in case I forgot something.


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There does not seem to be a problem with taking bc pills with antipsychotics as shown above.  I take Seroquel 600 mgs along with Yasmin with no problems.  Check out the bc pill info above.  Some pills are called mini pills, because they only contain progestin.  These pills can sometimes worsen depression.


Check out this link about the pill.

Katie ;)

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Is it safe to take birth control pills with antipsychotics?

It depends on which AP and which birth control pill -- they're too different individually to make blanket statements about them. Some may be more friendly towards each other than other combinations. Make sure your pdoc knows about the pill when s/he prescribes and AP, and it probably wouldn't hurt to check again with your pharmacist and/or the interaction checkers.

Where can I find information on this topic?
Your best sources may be some of the sites dedicated to birth control issues, and of course, your doctor and pharmacist.

Better yet, what do other women do?  What is safe?

Can't help here, sorry.


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Something else to keep in mind is that one often has to take a minimum of meds or take meds with worse side effects while pregnant.  It's not uncommon to have to chose between one's own mental health and the health of one's child, to have to chose between abortion and insanity.  Use multiple birth control methods just to be safe. 

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