Atypical antipsychotics (Second generation) updated on 06-10-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis

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.
S12449
R46723		 Halfdanarson (Controls exposed to FGA), 2022 Attention-deficit/hyperactivity disorder (ADHD) at age 3 or older (two recorded ICD-10 diagnosis F90.0, F90.1 or F90.2; or one recorded diagnosis and two prescription fills for centrally acting sympathomimetics) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.53 [0.44;0.65] C
excluded (control group) 		166/7,752   272/6,896 438 7,752
ref
S12448
R46721		 Halfdanarson (Controls unexposed, NOS), 2022 Attention-deficit/hyperactivity disorder (ADHD) at age 3 or older (two recorded diagnosis ICD-10 F90.0, F90.1 or F90.2; or one recorded diagnosis and two prescription fills for centrally acting sympathomimetics) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.00 [0.85;1.17] 166/7,752   71,775/4,308,620 71,941 7,752
ref
S12466
R46917		 Straub, 2022 Attention-deficit/hyperactivity disorder (ADHD) (≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings) - By 8 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 1.09 [0.97;1.23] 355/9,390   62,369/3,309,095 62,724 9,390
ref
S12454
R46736		 Wang a (Controls exposed to FGA), 2021 Diagnosis of attention-deficit/hyperactivity disorder (ADHD) - (ICD-9-CM code 314 or prescription for ADHD medication) - At least 6 years of follow-up during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.58 [0.25;1.34] C
excluded (control group) 		7/122   33/345 40 122
ref
S12453
R46732		 Wang a (Controls unexposed, NOS), 2021 Diagnosis of attention-deficit/hyperactivity disorder (ADHD) - (ICD-9-CM code 314 or prescription for ADHD medication) - At least 6 years of follow-up during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.48 [0.69;3.18] C 7/122   13,151/333,202 13,158 122
ref
S12458
R47069		 Yeh, 2021 Attention-deficit/hyperactivity disorder (ADHD - at least twice outpatient visits within each year for ICD-9 code: 314) - At 0-10 years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.38 [0.56;3.41] -/45   -/5,243 - 45
ref
Total 4 studies 1.07 [0.97;1.17] 147,823 17,309
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 Halfdanarson (Controls unexposed, NOS), 2022Halfdanarson, 2022 1 1.00[0.85; 1.17]71,9417,75235%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Straub, 2022Straub, 2022 1.09[0.97; 1.23]62,7249,39063%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Wang a (Controls unexposed, NOS), 2021Wang a, 2021 2 1.48[0.69; 3.18]13,1581222%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Yeh, 2021Yeh, 2021 1.38[0.56; 3.41]-451%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: critical Total (4 studies) I2 = 0% 1.07[0.97; 1.17]147,82317,3090.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS; 2: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.07[0.97; 1.17]147,82317,3090%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 Yeh, 2021 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.06[0.97; 1.17]147,82317,2640%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 3 unexposed, sickunexposed, sick 1.38[0.56; 3.41]-45 -NAYeh, 2021 1 Tags Adjustment   - No  - No 1.48[0.69; 3.18]13,158122 -NAWang a (Controls unexposed, NOS), 2021 1   - Yes  - Yes 1.06[0.96; 1.17]134,66517,1870%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Yeh, 2021 3 All studiesAll studies 1.07[0.97; 1.17]147,82317,3090%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 Yeh, 2021 40.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.11.10.5530.000Halfdanarson (Controls unexposed, NOS), 2022Straub, 2022Wang a (Controls unexposed, NOS), 2021Yeh, 2021

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 12454, 12449

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.06[0.97; 1.17]147,82317,2640%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 3 unexposed, sick controlsunexposed, sick controls 1.38[0.56; 3.41]-45 -NAYeh, 2021 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.54[0.44; 0.65]4787,8740%NAHalfdanarson (Controls exposed to FGA), 2022 Wang a (Controls exposed to FGA), 2021 20.510.01.0