Lamotrigine (All indications) 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.
S19371
R82155		 Straub (Lamotrigine) (Epilepsy), 2026 Attention deficit hyperactivity disorder (ADHD) - ICD-10 codes: F90.x - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.09 [0.86;1.38] 102/3,273   366/8,887 468 3,273
ref
S17412
R73048		 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 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 (general population or NOS) Adjustment: Yes Partial overlapping 0.86 [0.75;0.98] 243/5,035   147,608/2,651,210 147,851 5,035
ref
S17413
R73054		 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, sibling) (Mixed indications), 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 sibling excluded Adjustment: Yes Partial overlapping 0.76 [0.56;1.03]
excluded (control group) 		-/-   -/- - -
ref
S17266
R72284		 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median 6.18 (3.53-9.94) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 1.64 [0.93;2.89] 14/939   4,794/514,066 4,808 939
ref
S17274
R72308		 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, sibling) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median 6.18 (3.53-9.94) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) sibling excluded Adjustment: Yes 5.97 [1.69;21.11]
excluded (control group) 		-/-   -/- - -
ref
S17470
R73443		 Dreier (Lamotrigine) (Epilepsy), 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 0.83 [0.66;1.04] 95/5,288   528/22,203 623 5,288
ref
S8933
R30194		 Bromley (Lamotrigine) (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 7.24 [0.14;371.71] C
excluded (control group) 		0/30   0/214 0 30
ref
S8936
R30210		 Bromley (Lamotrigine) (Controls unexposed, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.86 [0.02;45.15] C 0/30   0/26 0 30
ref
Total 5 studies 0.96 [0.80;1.14] 153,750 14,565
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 Straub (Lamotrigine) (Epilepsy), 2026Straub, 2026 1 1.09[0.86; 1.38]4683,27326%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_SE, 2024 2 0.86[0.75; 0.98]147,8515,03538%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK, 2024 3 1.64[0.93; 2.89]4,8089398%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Dreier (Lamotrigine) (Epilepsy), 2023Dreier, 2023 4 0.83[0.66; 1.04]6235,28827%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Bromley (Lamotrigine) (Controls unexposed, sick), 2013Bromley, 2013 5 0.86[0.02; 45.15]0300%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 48% 0.96[0.80; 1.14]153,75014,5650.25.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Lamotrigine) (Epilepsy; 2: Lamotrigine) (Controls unexposed, general pop) (Mixed indications; 3: Lamotrigine) (Controls unexposed, general pop) (Mixed indications; 4: Lamotrigine) (Epilepsy; 5: Lamotrigine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.96[0.80; 1.14]153,75014,56548%NAStraub (Lamotrigine) (Epilepsy), 2026 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Lamotrigine) (Epilepsy), 2023 Bromley (Lamotrigine) (Controls unexposed, sick), 2013 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.12[0.60; 2.08]152,6595,97479%NAMadley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 2 unexposed, sickunexposed, sick 0.95[0.77; 1.17]1,0918,59125%NAStraub (Lamotrigine) (Epilepsy), 2026 Dreier (Lamotrigine) (Epilepsy), 2023 Bromley (Lamotrigine) (Controls unexposed, sick), 2013 3 Tags Adjustment   - No  - No 0.86[0.02; 45.15]-30 -NABromley (Lamotrigine) (Controls unexposed, sick), 2013 1   - Yes  - Yes 0.96[0.79; 1.17]153,75014,53561%NAStraub (Lamotrigine) (Epilepsy), 2026 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Lamotrigine) (Epilepsy), 2023 4 Partial overlappingPartial overlapping 0.86[0.75; 0.98]147,8515,035 -NAMadley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 1 All studiesAll studies 0.96[0.80; 1.14]153,75014,56548%NAStraub (Lamotrigine) (Epilepsy), 2026 Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Lamotrigine) (Epilepsy), 2023 Bromley (Lamotrigine) (Controls unexposed, sick), 2013 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.74.72.4220.000Straub (Lamotrigine) (Epilepsy), 2026Madley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024Dreier (Lamotrigine) (Epilepsy), 2023Bromley (Lamotrigine) (Controls unexposed, sick), 2013

Asymetry test p-value = 0.3622 (by Egger's regression)

slope=-0.2043 (0.1256); intercept=1.1581 (1.0802); t=1.0722; p=0.3622

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8933, 17413, 17274

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.17[0.63; 2.16]152,6596,00466%NAMadley-Dowd_SE (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, general pop) (Mixed indications), 2024 Bromley (Lamotrigine) (Controls unexposed, disease free), 2013 3 unexposed, sick controlsunexposed, sick controls 0.95[0.77; 1.17]1,0918,59125%NAStraub (Lamotrigine) (Epilepsy), 2026 Dreier (Lamotrigine) (Epilepsy), 2023 Bromley (Lamotrigine) (Controls unexposed, sick), 2013 3 siblingssiblings 1.94[0.26; 14.48]--90%NAMadley-Dowd_SE (Lamotrigine) (Controls unexposed, sibling) (Mixed indications), 2024 Madley-Dowd_UK (Lamotrigine) (Controls unexposed, sibling) (Mixed indications), 2024 20.510.01.0