Fluoxetine updated on 07-01-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S18377
R77489
Heuvelman, 2023 Attention deficit hyperactivity disorder -Medical codes or therapy records that indicated that the child had been prescribed ADHD medication - Mean age at end of follow-up 10.04 years, range 4–22 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.12 [0.82;1.51] -/4,767   -/16,330 - 4,767
ref
S18251
R76869
Suarez (Controls unexposed, discontinuers), 2022 Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.10 [0.92;1.32] 1,059/26,595   225/7,773 1,284 26,595
ref
S18252
R76870
Suarez (Controls unexposed, general pop), 2022 Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.21 [1.13;1.30]
excluded (control group)
1,059/26,659   52,366/2,984,014 53,425 26,659
ref
Total 2 studies 1.11 [0.95;1.29] 1,284 31,362
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Heuvelman, 2023Heuvelman, 2023 1.12[0.82; 1.51]-4,76726%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: criticalROB mesure: moderateROB reporting: low Suarez (Controls unexposed, discontinuers), 2022Suarez, 2022 1 1.10[0.92; 1.32]1,28426,59574%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 1.11[0.95; 1.29]1,28431,3620.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, discontinuers;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Tags Adjustment   - Yes  - Yes 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Monotherapy   - no or not specified  - no or not specified 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.12[0.83; 1.52]-4,767 -NAHeuvelman, 2023 1   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.10[0.92; 1.32]1,28426,595 -NASuarez (Controls unexposed, discontinuers), 2022 1 All studiesAll studies 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 20.55.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 18252

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.21[1.13; 1.30]53,42526,659 -NASuarez (Controls unexposed, general pop), 2022 1 unexposed, sick controlsunexposed, sick controls 1.11[0.95; 1.29]1,28431,3620%NAHeuvelman, 2023 Suarez (Controls unexposed, discontinuers), 2022 20.510.01.0