Carbamazepine (Epilepsy) updated on 04-22-2025

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.
S17426
R73185		 Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 2.40 [1.88;3.06] C
excluded (control group) 		190/1,842   109/2,383 299 1,842
ref
S17427
R73189		 Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Partial overlapping 1.00 [0.85;1.18] 190/1,842   929/10,769 1,119 1,842
ref
S17257
R72224		 Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median CBZ 9.17 (5.31-12.54) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.36 [0.61;3.02] C
excluded (control group) 		11/460   14/791 25 460
ref
S17107
R72200		 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median CBZ 9.17 (5.31-12.54) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 2.29 [1.14;4.60] 11/460   38/4,075 49 460
ref
S15868
R65357		 Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 1.89 [1.41;2.53] C
excluded (control group) 		89/2,665   95/5,288 184 2,665
ref
S15869
R65373		 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.05 [0.81;1.37] 89/2,665   528/22,203 617 2,665
ref
S7510
R22490		 Huber-Mollema (Carbamazepine), 2019 Diagnosis of ADHD throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.95 [0.18;5.12] C 2/37   5/88 7 37
ref
S6661
R18416		 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.82 [0.07;46.28] C
excluded (control group) 		1/50   0/30 1 50
ref
S6660
R18412		 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 13.21 [0.53;329.15] C
excluded (control group) 		1/50   0/214 1 50
ref
S5486
R18101		 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.58 [0.06;40.13] C 1/50   0/26 1 50
ref
S5542
R21087		 Cohen (Carbamazepine), 2013 Children with either ADHD inattentive OR combined types > 1 SD (from the Attention Problems and Hyperactivity scales of the BASC) (Both Parent and Teacher) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.96 [0.22;4.25] C 4/32   4/31 8 32
ref
Total 6 studies 1.05 [0.91;1.23] 1,801 5,086
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 Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024Madley-Dowd_SE, 2024 1 1.00[0.85; 1.18]1,1191,84264%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024Madley-Dowd_UK, 2024 2 2.29[1.14; 4.60]494605%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 3 1.05[0.81; 1.37]6172,66529%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huber-Mollema (Carbamazepine), 2019Huber-Mollema, 2019 4 0.95[0.18; 5.12]7371%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 5 1.58[0.06; 40.13]1500%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine), 2013Cohen, 2013 6 0.96[0.22; 4.25]8321%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: low Total (6 studies) I2 = 4% 1.05[0.91; 1.23]1,8015,0860.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Controls unexposed, sick; 2: Carbamazepine) (Controls unexposed, sick; 3: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 4: Carbamazepine; 5: Carbamazepine) (Controls unexposed, sick; 6: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.05[0.91; 1.23]1,8015,0864%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.11[0.87; 1.42]1,7865,01742%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 4 exposed to other treatment, sickexposed to other treatment, sick 0.96[0.31; 2.92]15690%NAHuber-Mollema (Carbamazepine), 2019 Cohen (Carbamazepine), 2013 2 Tags Adjustment   - No  - No 1.01[0.35; 2.89]161190%NAHuber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 3   - Yes  - Yes 1.13[0.86; 1.49]1,7854,96761%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 3 Partial overlappingPartial overlapping 1.00[0.85; 1.18]1,1191,842 -NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 1 All studiesAll studies 1.05[0.91; 1.23]1,8015,0864%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 60.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.93.91.9810.000Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Huber-Mollema (Carbamazepine), 2019Bromley (Carbamazepine) (Controls unexposed, sick), 2013Cohen (Carbamazepine), 2013

Asymetry test p-value = 0.3790 (by Egger's regression)

slope=-0.0269 (0.1009); intercept=0.5898 (0.5968); t=0.9882; p=0.3790

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6661, 6660, 15868, 17426, 17257

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale13.21[0.53; 329.15]150 -NABromley (Carbamazepine) (Controls unexposed, disease free), 2013 1 unexposed, sick controlsunexposed, sick controls 1.11[0.87; 1.42]1,7865,01742%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.08[1.74; 2.49]5245,0860%NAMadley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024 Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Cohen (Carbamazepine), 2013 60.510.01.0