Topiramate (All indications) updated on 04-22-2025

Cognitive developmental disorders/delay (> 6 years old)

id	Study   Auto Madley-Dowd_SE (Topiramate) (Controls exposed to LTG) (Mixed indications), 2024Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_SE (Topiramate) (Controls unexposed, sibling) (Mixed indications), 2024Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023Bromley (Topiramate), 2016	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 trimester	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.
S17420 R73140	Madley-Dowd_SE (Topiramate) (Controls exposed to LTG) (Mixed indications), 2024	Intellectual disability (intelligence quotient below 70) - 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: Yes	2.19 [1.00;4.81] excluded (control group)	7/264   60/5,035	67	264		ref
S17421 R73146	Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes	2.40 [1.14;5.06]	7/264   24,323/2,651,210	24,330	264		ref
S17422 R73152	Madley-Dowd_SE (Topiramate) (Controls unexposed, sibling) (Mixed indications), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups)	during pregnancy (anytime or not specified)	population based cohort retrospective	sibling excluded	Adjustment: Yes	1.51 [0.30;7.50] excluded (control group)	-/-   -/-	-	-		ref
S17468 R73418	Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023	Intellectual disability - 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	2.71 [1.05;6.98] C excluded (control group)	5/290   34/5,288	39	290		ref
S17469 R73428	Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023	Intellectual disability - 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	2.23 [0.90;5.50]	5/290   184/22,203	189	290		ref
S8582 R53759	Bromley (Topiramate), 2016	Full-scale IQ <85 (Wechsler Preschool and Primary Scale of Intelligence (WPPSI) / Wechsler Intelligence Scale for Children (WISC)) (5-9 years old)	during pregnancy (anytime or not specified)	retrospective cohort (registry)	unexposed, sick	Adjustment: No	2.17 [0.41;11.53] C	3/27   3/55	6	27		ref
					Total	3 studies	2.31 [1.34;3.98]		24,525	581
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 17468, 17420, 17422

Umbrella review (other published meta-analyses)