The drugs Symla and Escitalopram Actavis (as I guess, because you did not give the full name of the drug) do not significantly affect the action or effectiveness of hormonal contraception. Therefore, they should not contribute to the occurrence of spotting and lower abdominal pain.

If you have not previously experienced irregular spotting while using Asubtela tablets, it is worth consulting a gynaecologist who will conduct appropriate tests to rule out non-hormonal causes of bleeding.

It is also worth taking into account that often under the influence of hormonal contraception (especially with prolonged use), the uterine lining becomes thin, which increases the risk of mid-cycle bleeding and spotting. Excessive stress can also cause spotting.

If you have not consulted your doctor about combining Symla with contraception, it is worth doing so. According to the study, during the week when hormonal contraceptives are interrupted, a twofold increase in plasma levels of lamotrigine was observed, which may cause side effects. Therefore, the use of contraception that does not require a one-week break or the use of non-hormonal methods of contraception should be considered.

Below I have attached materials that may be of interest to you:

https://www.gdziepolek.pl/artykuly/jak-prawidlowo-stosowac-antykoncepcje

https://www.gdziepolek.pl/artykuly/jakie-leki-oslabiaja-skutecznosc-antykoncepcji

https://www.gdziepolek.pl/artykuly/czy-jedzenie-i-picie-obnizaja-skutecznosc-antykoncepcji

https://www.gdziepolek.pl/blog/historia-antykoncepcji-metody-zapobiegania-ciazy-kiedys-i-dzis