Amitriptyline updated on 07-01-2025

All congenital malformations (majors, minors, majors and minors, or unspecified)

id	Study   Auto Chan (Controls exposed to SSRIs), 2024Chan (Controls unexposed, general pop), 2024Anderson, 2020Ozturk, 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 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.
S18162 R76886	Chan (Controls exposed to SSRIs), 2024	Any major malformations	1st trimester	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.12 [0.59;2.11] C excluded (control group)	12/148   70/956	82	148		ref
S18150 R76887	Chan (Controls unexposed, general pop), 2024	Any major malformations	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.53 [0.84;2.77]	12/148   22,628/462,377	22,640	148		ref
S11188 R42241	Anderson, 2020	Major birth defects	1st trimester	case control	unexposed (general population or NOS)	Adjustment: No Monotherapy: TCA only	0.91 [0.38;2.19] C	17/24   30,613/42,084	30,630	24		ref
S11597 R42499	Ozturk, 2016	Major congenital defects	at least 1st trimester	prospective cohort	unexposed (general population or NOS)	Adjustment: No Monotherapy: no or not specified	9.90 [0.43;229.94] C	0/4   3/246	3	4		ref
					Total	3 studies	1.36 [0.74;2.49]		53,273	176
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 18162