Abstract Details

Title Relative Risks of Changes in Seizure Frequency with Hormonal Contraception Vary by Antiepileptic Drug Category

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S08 - (-)

Poster/Presentation
Number 006

Objective

Background Reciprocal interactions occur between some contraceptive hormones and some AEDs but we know little about their consequences on seizure frequency.

Design/Methods The Epilepsy Birth Control Registry is a web-based survey that gathers demographic, epilepsy, AED, contraceptive and reproductive data from WWE in the community. These retrospective data come from 1057 contraceptive experiences reported by the first 500 WWE, ages 18-47 years, who completed the survey. We determined relative risks (RRs) of increase and decrease in seizures reported on HC (oral combined or progestin contraceptive pills, depomedroxyprogesterone, hormonal patch, implanted hormones, vaginal ring), stratified by AED categories (EIAED - enzyme inducing AED, GluAED - glucuronidated AED [lamotrigine], NEIAED - non EIAED, EnzInhAED - enzyme inhibiting AED [valproate] and no AED).

Results AED category showed a significant effect on the RRs of reported seizure increase with HC. The lowest rate of seizure increase occurred with NEIAEDs (8.1%). RRs compared to NEIAED were No AED: 2.2 [0.89-5.6], p = .09; EIAED: 3.1 [1.4-7.2], p = .0067; GluAED: 2.9 [1.2-6.8], p = .0145; EnzInhAED: 4.7 [2.0-11.1], p = .0004. RR of seizure decrease reported with HC was highest with NEIAED 18.9%. RRs of seizure decrease compared to NEIAED were not significantly different for any other AED category although the RR for EnzInhAEDs (4.8%) did show a trend at RR = .25 [.06-1.1] p = .0591.

Conclusions Interim retrospective survey findings suggest that the RRs of changes in seizure frequency with HC vary by AED category with NEIAEDs showing the most favorable interaction and EnzInhAED (valproate) showing the least favorable interaction with regard to seizure control.

Authors/Disclosures
Andrew G. Herzog, MD, MSc, FAAN PRESENTER	Dr. Herzog has nothing to disclose.
Hannah Mandle	No disclosure on file
	No disclosure on file
Kristen Fowler (Beth Israel Deaconess Medical Center)	No disclosure on file
Anne R. Davis, MD (Columbia University Medical Center)	Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Exeltis. Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan . Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for ACLU. Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Planned Parenthood Federation of America .
W. A. Hauser, MD, FAAN (Columbia University)	No disclosure on file
Omar A. Khan, MD, PhD (Dept of Neuro/Wayne State Univ Sch of Med)	No disclosure on file

��ɫ��

��ɫ��