Carbamazepine (Epilepsy) updated on 04-22-2025

ASD (Autism spectrum disorder): Diagnosis/Risk

id	Study   Auto Karayagmurlu (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026Karayagmurlu (Controls unexposed, disease free) (Carbamazepine) (Epilepsy), 2026Karayagmurlu (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG), 2024Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Blotiere (Carbamazepine), 2020Huber-Mollema (Carbamazepine), 2019Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018Bjørk (Carbamazepine) (Controls unexposed, disease free), 2018Bjørk (Carbamazepine) (Controls unexposed, sick), 2018Wood (Carbamazepine), 2015Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013Bromley (Carbamazepine) (Controls unexposed, disease free), 2013Bromley (Carbamazepine) (Controls unexposed, sick), 2013	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S19443 R82902	Karayagmurlu (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026	Autism Spectrum Disorder - DSM-5 clinical evaluation conducted by an experienced child and adolescent psychiatrist - Aged 2–6 years	during pregnancy (anytime or not specified)	retrospective cohort	exposed to other treatment, sick excluded	Adjustment: No	1.00 [0.04;28.30] C excluded (control group)	1/18   0/6	1	18		ref
S19446 R82908	Karayagmurlu (Controls unexposed, disease free) (Carbamazepine) (Epilepsy), 2026	Autism Spectrum Disorder - DSM-5 clinical evaluation conducted by an experienced child and adolescent psychiatrist - Aged 2–6 years	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, disease free excluded	Adjustment: No	9.55 [0.37;245.72] C excluded (control group)	1/18   0/53	1	18		ref
S19450 R82916	Karayagmurlu (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026	Autism Spectrum Disorder - DSM-5 clinical evaluation conducted by an experienced child and adolescent psychiatrist - Aged 2–6 years	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: No	3.36 [0.13;88.39] C	1/18   0/19	1	18		ref
S19457 R82945	Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026	Autism spectrum disorder - ICD-10 codes: F84.x (except F84.2, F84.3) - Mean follow up (full cohort): 3.4 years	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No	1.37 [0.80;2.36] C excluded (control group)	22/1,548   34/3,273	56	1,548		ref
S19467 R83022	Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026	Autism spectrum disorder - ICD-10 codes: F84.x (except F84.2, F84.3) - Mean follow up (full cohort): 3.4 years	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes	0.88 [0.54;1.45]	22/1,548   106/8,887	128	1,548		ref
S17426 R73197	Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024	Autism - ICD-8/9/10 codes - 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	2.47 [1.76;3.47] C excluded (control group)	98/1,842   53/2,383	151	1,842		ref
S17427 R73198	Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024	Autism - ICD-8/9/10 codes - Mean 5-20 years old (according groups)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes Partial overlapping	1.16 [0.92;1.45]	98/1,842   425/10,769	523	1,842		ref
S17257 R72269	Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG), 2024	Autism - ICD10 codes - 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	1.75 [0.88;3.46] C excluded (control group)	17/460   17/791	34	460		ref
S17107 R72270	Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024	Autism - ICD10 codes - Median CBZ 9.17 (5.31-12.54) years old	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes	1.68 [0.91;3.09]	17/460   78/4,075	95	460		ref
S15868 R65362	Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Autism spectrum disorder - 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	1.31 [0.88;1.93] C excluded (control group)	42/2,665   64/5,288	106	2,665		ref
S15869 R65378	Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Autism spectrum disorder - 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	1.03 [0.70;1.51]	42/2,665   323/22,203	365	2,665		ref
S10075 R46619	Blotiere (Carbamazepine), 2020	Diagnosis Pervasive developmental disorders (F84) (mean age of 3.7 years old)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick	Adjustment: No	0.80 [0.05;14.03] C	0/176   7/2,108	7	176		ref
S7510 R46620	Huber-Mollema (Carbamazepine), 2019	Diagnosis of autism spectrum disorder	throughout pregnancy	prospective cohort	exposed to other treatment, sick	Adjustment: No	1.20 [0.21;6.85] C	2/37   4/88	6	37		ref
S9978 R46623	Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018	Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13)	during pregnancy (anytime or not specified)	population based cohort propective	exposed to other treatment, sick excluded	Adjustment: No	0.83 [0.29;2.38] C excluded (control group)	6/41   13/76	19	41		ref
S9979 R46624	Bjørk (Carbamazepine) (Controls unexposed, disease free), 2018	Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13)	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, disease free excluded	Adjustment: No	1.70 [0.72;4.05] C excluded (control group)	6/41   6,907/75,497	6,913	41		ref
S9980 R46625	Bjørk (Carbamazepine) (Controls unexposed, sick), 2018	Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13)	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, sick	Adjustment: No	1.56 [0.60;4.03] C	6/41   27/272	33	41		ref
S6181 R46622	Wood (Carbamazepine), 2015	Score >30 (CARS)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	0.78 [0.03;21.03] C	1/34   0/9	1	34		ref
S6661 R46616	Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	Autistic Spectrum Disorders (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.19 [0.01;4.87] C excluded (control group)	0/50   1/30	1	50		ref
S6660 R46617	Bromley (Carbamazepine) (Controls unexposed, disease free), 2013	Autistic Spectrum Disorders (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No	0.47 [0.02;8.88] C excluded (control group)	0/50   4/214	4	50		ref
S5486 R46618	Bromley (Carbamazepine) (Controls unexposed, sick), 2013	Autistic Spectrum Disorders (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	0.52 [0.01;26.73] C	0/50   0/26	0	50		ref
					Total	10 studies	1.14 [0.96;1.35]		1,159	6,871
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 6661, 6660, 9978, 9979, 15868, 17426, 17257, 19443, 19446, 19457

Umbrella review (other published meta-analyses)