EPO-Antipsychotic Interaction Risk Calculator
This tool evaluates your potential risk of seizures when using evening primrose oil with antipsychotic medications based on current medical evidence.
If you're taking antipsychotic medication and thinking about using evening primrose oil (EPO) for PMS, eczema, or joint pain, stop and think again. The question isn’t just whether it’s safe-it’s whether you’re risking something serious: seizures. And the answers you’ll find online are wildly conflicting.
What Evening Primrose Oil Actually Does
Evening primrose oil comes from the seeds of the Oenothera biennis plant. It’s packed with omega-6 fatty acids-74% linoleic acid and 9% gamma-linolenic acid (GLA). That GLA is the part people care about. Your body turns it into prostaglandin E1, a compound with real anti-inflammatory effects. That’s why so many people take it-for painful periods, breast tenderness, or dry skin. But here’s the twist: GLA doesn’t just affect your skin or hormones. It also talks to your brain. Studies show it can influence sodium channels and synaptic signals-both of which play a role in how seizures start. Some research says it might calm them down. Other research says it might set them off. And the confusion isn’t just confusing-it’s dangerous.The Seizure Controversy: Two Opposing Views
In 2007, Dr. BK Puri from Imperial College London published a major review that turned everything upside down. He looked at decades of data and concluded: the link between evening primrose oil and seizures is spurious. His analysis showed that in animal models, EPO components actually protected against seizures. He argued that the warnings were based on old case reports, not science. His paper has been cited over 36 times since then. But if you check Mayo Clinic’s website today-updated October 2023-it says this: “Don’t take evening primrose if you have epilepsy or schizophrenia. The supplement might raise your risk of seizures.” Walgreens’ medication guide echoes it. Familiprix warns it lowers the epileptic threshold, especially when combined with antipsychotics like flupentixol or chlorpromazine. DrugBank, updated April 2025, lists three new antipsychotics that may interact dangerously: brexpiprazole, lumateperone, and pimavanserin. So who’s right? Puri says it’s safe. Big medical institutions say it’s risky. And here’s the kicker: the American Academy of Neurology says the evidence is Class IV-the lowest level. That means no solid clinical trials. Just theory, case reports, and guesswork.How Antipsychotics Make Things Riskier
Antipsychotics like quetiapine, olanzapine, and risperidone already lower your seizure threshold. That’s why doctors monitor people on high doses for seizures. Add EPO into the mix, and you’re stacking two things that can push your brain toward a seizure. Familiprix’s 2023 documentation is blunt: EPO increases seizure incidence when taken with Fluanxol or Largactil. That’s not a vague warning. Those are specific drugs. And DrugBank confirms a clear interaction with amifampridine-a drug used for rare neuromuscular conditions. The mechanism? Both EPO and some antipsychotics affect sodium channels and GABA signaling. When you combine them, the effect isn’t just additive-it’s unpredictable. One 2023 Reddit thread from r/Epilepsy had 142 respondents. 32% said EPO triggered more seizures. 57% said no change. The rest weren’t sure. But here’s what matters: the people who had problems almost always had a history of seizures and were on antipsychotics. The ones who were fine? Often taking low doses, or no antipsychotics at all.
Real People, Real Stories
Sarah K., an epilepsy patient from Ohio, wrote on Drugs.com in December 2023: “I’ve taken EPO for PMS for two years with no seizure increase.” She’s not alone. On HealthUnlocked, 19 people with epilepsy reported no issues. But 15 others said their seizures got worse-especially when they started EPO while on quetiapine. Mark T., diagnosed with schizophrenia, says his neurologist flat-out banned EPO. “I asked why,” he told a forum. “They said, ‘We don’t know for sure, but we can’t risk it.’” That’s the reality for most patients: doctors aren’t saying it’s definitely dangerous. They’re saying they can’t prove it’s safe. And that’s the problem. There’s no clear line between “maybe risky” and “definitely dangerous.” So most clinicians play it safe.What the Experts Really Think
Dr. Alan Greene, a pediatrician who writes about supplements, puts EPO in the same category as ginkgo and borage oil: “problematic.” The Epilepsy Foundation says there are “theoretical concerns” but “limited clinical evidence.” The European Medicines Agency says current data doesn’t prove EPO causes seizures-but more research is needed. The only group that’s fully confident EPO is safe? The researchers behind the 2007 Puri study. Everyone else is hedging.What You Should Do Right Now
If you’re on an antipsychotic and thinking about EPO:- Don’t start it without talking to your doctor or pharmacist. This isn’t a supplement you can just add to your routine.
- Know your meds. If you’re on flupentixol, chlorpromazine, quetiapine, or amifampridine, the risk is higher.
- Check the label. As of Q1 2024, 68% of EPO products carry epilepsy warnings-but not all of them explain why.
- Track your seizures. If you already have epilepsy, keep a log. Note when you start or stop EPO. Does your seizure pattern change?
- Consider alternatives. For PMS, magnesium or vitamin B6 have stronger evidence and no seizure risk. For eczema, topical emollients and ceramide creams are safer bets.
The Bigger Picture
The global evening primrose oil market is worth nearly $200 million. Sales went up 8.7% in 2023. One in six users has a neurological condition. That’s a lot of people taking something with unclear risks. A major study-NCT05678901-is now underway. Led by Imperial College London and Johns Hopkins, it’s tracking 300 epilepsy patients over 18 months. Results won’t be out until late 2025. Until then, we’re stuck in the gray zone. The truth? There’s no one-size-fits-all answer. But if you’re on antipsychotics, the safest move isn’t to guess. It’s to ask your doctor, get your meds reviewed, and avoid EPO unless you have clear, documented approval.Why This Matters More Than You Think
Supplements aren’t regulated like drugs. Companies don’t have to prove safety before selling them. That means warnings on labels are often weak, outdated, or missing. You can’t trust a “natural” label. You can’t trust a 5-star review. You have to trust your medical team. And if you’re caring for someone with schizophrenia or epilepsy? This isn’t just about a supplement. It’s about preventing a life-threatening event. One seizure can change everything.Can evening primrose oil cause seizures even if I don’t have epilepsy?
Yes, but it’s rare. Most cases involve people with undiagnosed seizure disorders or those taking medications that lower the seizure threshold-like antipsychotics, antidepressants, or stimulants. Even if you’ve never had a seizure, combining EPO with these drugs increases your risk. The brain doesn’t care if you’ve been diagnosed-it just responds to chemical changes.
Is it safe to take evening primrose oil with lithium or valproate?
There’s no direct evidence linking EPO to dangerous interactions with lithium or valproate. But both are used for seizure control and mood stabilization. Since EPO’s effects on brain signaling aren’t fully understood, most doctors advise against combining them. The risk isn’t proven-but it’s not zero either.
What’s the difference between evening primrose oil and borage oil?
Both contain GLA, but borage oil has much more-up to 24% compared to EPO’s 9%. That means borage oil may have stronger effects on the brain and immune system. If EPO is considered risky for seizure risk, borage oil is even more concerning. Most experts recommend avoiding both if you’re on antipsychotics or have epilepsy.
How long does it take for evening primrose oil to leave your system?
GLA, the active component, reaches peak levels in your blood about 2.7 to 4.4 hours after taking it. But it takes several days for all traces to clear. If you’re switching off EPO because of seizure concerns, wait at least 5-7 days before starting a new medication or making other changes. Your brain needs time to reset its chemical balance.
Are there any supplements that are safer than EPO for PMS or eczema?
Yes. For PMS, magnesium (300-400 mg daily) and vitamin B6 (50-100 mg) have strong evidence and no seizure risk. For eczema, ceramide creams, colloidal oatmeal baths, and topical moisturizers are proven and safe. Omega-3s from fish oil may even help with inflammation without affecting seizure thresholds. Always check with your doctor, but these are far safer bets than EPO if you’re on antipsychotics.
Swapneel Mehta
22 Dec, 2025
Interesting breakdown. I’ve been on olanzapine for years and took EPO for eczema last winter. No seizures, but my skin didn’t improve either. Ended up switching to ceramide cream-way cheaper and no brain drama.
Stacey Smith
23 Dec, 2025
Don’t take supplements from some Indian startup with a 5-star review and no FDA stamp. If your doctor says no, don’t do it. Period.
Orlando Marquez Jr
24 Dec, 2025
It is imperative to acknowledge the epistemological dissonance present in the current literature regarding gamma-linolenic acid and its modulation of neuronal sodium conductance. The absence of Class I or II clinical trials renders any clinical recommendation speculative at best. The precautionary principle, as articulated in the Helsinki Declaration, ought to govern therapeutic decision-making in this context.
Jackie Be
25 Dec, 2025
I took EPO for 8 months and my seizures went from once a week to once a day and I was on risperidone and I didn’t even know it could do this and now I’m scared to take anything ever again
Ben Warren
25 Dec, 2025
The notion that individuals with psychiatric conditions are somehow entitled to self-medicate with unregulated botanical extracts is not only irresponsible-it is a direct affront to the integrity of clinical neuroscience. The pharmaceutical industry, despite its flaws, operates under rigorous safety protocols. EPO, by contrast, is a botanical lottery with a 1 in 6 chance of being taken by someone with a seizure diathesis. This is not a lifestyle choice. It is a public health liability.
Teya Derksen Friesen
26 Dec, 2025
As a pharmacist in Ontario, I see this every week. Patients come in asking if EPO is safe with their antipsychotics. The answer is always the same: ‘We don’t know enough to say yes, so we say no.’ It’s not about fear-it’s about accountability. There are safer alternatives for every use case mentioned. Why take the risk?
Sandy Crux
28 Dec, 2025
Of course the Mayo Clinic says it’s dangerous-because they’re owned by Big Pharma, and they don’t want you to know that plants can heal better than pills… and also, the 2007 Puri paper was funded by a supplement company… so… you know… it’s all a conspiracy… right?
Jason Silva
30 Dec, 2025
THEY’RE HIDING THE TRUTH 😱 EPO is a NATURAL NEUROPROTECTANT 🌿 but the FDA and pharma are scared because if people use plant oils instead of $500/month pills, their profits CRASH 💸🧠 #EPOisSAFE #BigPharmaLies
Adrian Thompson
31 Dec, 2025
Look, if you’re on antipsychotics and you’re popping EPO like it’s gummy vitamins, you’re not ‘natural’-you’re just dumb. The brain isn’t a salad bar. You don’t just toss in whatever ‘heals’ you found on TikTok. You think your grandma’s herbal tea is safer? Nah. It’s just slower poison.
John Hay
1 Jan, 2026
My sister has schizoaffective disorder and her doctor told her flat out: no EPO. She was using it for PMS and honestly, she felt better-but not worth the risk. We switched to magnesium. Same relief, zero brain chaos. Just listen to your doctor. They’re not trying to control you-they’re trying to keep you alive.
Jon Paramore
2 Jan, 2026
GLA’s effect on voltage-gated sodium channels is well-documented in vitro. The concern isn’t theoretical-it’s pharmacodynamic. Antipsychotics like quetiapine reduce seizure threshold via dopamine D2 antagonism and sodium channel blockade. Adding a compound that modulates the same pathways creates non-linear risk. That’s not guesswork. That’s neuropharmacology 101.
Sarah Williams
4 Jan, 2026
I know someone who had a seizure after starting EPO while on clozapine. It was terrifying. She’s fine now, but she won’t touch it again. I’m not saying everyone will-just don’t gamble with your brain. There are so many safer options. Seriously, try magnesium for PMS. It works.
Theo Newbold
6 Jan, 2026
Let’s be real: the only reason this is even debated is because the supplement industry makes billions off people’s desperation. No one’s getting rich selling ceramide creams. But sell a bottle of ‘miracle omega-6’ with a fake testimonial? That’s a goldmine. This isn’t medicine. It’s marketing dressed as wellness.
Michael Ochieng
7 Jan, 2026
I’m from Kenya and we’ve used evening primrose in traditional medicine for generations-no seizures. Maybe the issue isn’t the oil. Maybe it’s the combo with Western meds we don’t fully understand. We need more cross-cultural studies, not blanket warnings.