Citalopram updated on 07-01-2025

Digestive system anomalies

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.
S7437
R21931		 Bérard, 2017 Digestive system malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.13 [0.55;2.32] -/584   -/14,847 - 584
ref
S7351
R21528		 Wemakor, 2015 Digestive system anomalies 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.62 [0.15;2.67] C 2/22   2,737/19,800 2,739 22
ref
S5884
R14734		 Ban (Controls unexposed, disease free), 2014 Digestive system malformations 1st trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 2.60 [1.07;6.32] -/1,946   313/325,294 - 1,946
ref
S6014
R15487		 Jimenez-Solem (Controls unexposed, NOS), 2012 Congenital malformations of the digestive system 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 2.50 [1.19;5.27]
excluded (control group) 		7/1,606   1,545/843,797 1,552 1,606
ref
S6019
R15598		 Jimenez-Solem (Controls unexposed, sick), 2012 Congenital malformations of the digestive system 1st trimester population based cohort retrospective unexposed, sick Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 3.52 [0.43;28.69] C 7/1,606   1/806 8 1,606
ref
S7179
R20211		 Colvin, 2011 Gastrointestinal defects (ICD 749–751) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.14 [0.47;2.77] 5/775   534/94,561 539 775
ref
S6241
R16485		 Malm, 2011 Digestive system 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 0.92 [0.46;1.85] -/2,799   -/628,607 - 2,799
ref
Total 6 studies 1.24 [0.84;1.82] 3,286 7,732
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 Bérard, 2017Bérard, 2017 1.13[0.55; 2.32]-58426%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 0.62[0.15; 2.67]2,739227%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, disease free), 2014Ban, 2014 1 2.60[1.07; 6.32]-1,94618%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Jimenez-Solem (Controls unexposed, sick), 2012Jimenez-Solem, 2012 2 3.52[0.43; 28.69]81,6063%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Colvin, 2011Colvin, 2011 1.14[0.47; 2.77]53977518%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Malm, 2011Malm, 2011 0.92[0.46; 1.85]-2,79928%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 5% 1.24[0.84; 1.82]3,2867,7320.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, disease free; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.30[0.87; 1.96]5477,7109%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 Colvin, 2011 Malm, 2011 5 case control studiescase control studies 0.62[0.15; 2.67]2,73922 -NAWemakor, 2015 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[0.71; 2.10]3,2785,54230%NAWemakor, 2015 Ban (Controls unexposed, disease free), 2014 Colvin, 2011 Malm, 2011 4 unexposed, sickunexposed, sick 1.28[0.64; 2.57]82,1901%NABérard, 2017 Jimenez-Solem (Controls unexposed, sick), 2012 2 Tags Adjustment   - No  - No 1.12[0.55; 2.29]3,2862,4030%NAWemakor, 2015 Jimenez-Solem (Controls unexposed, sick), 2012 Colvin, 2011 3   - Yes  - Yes 1.32[0.74; 2.34]-5,32942%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Malm, 2011 3 Monotherapy   - no or not specified  - no or not specified 0.92[0.46; 1.84]-2,799 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.01[0.53; 1.92]2,7396060%NABérard, 2017 Wemakor, 2015 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.83[0.99; 3.39]5474,3273%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 Colvin, 2011 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 3.52[0.43; 28.69]81,606 -NAJimenez-Solem (Controls unexposed, sick), 2012 1 All studiesAll studies 1.24[0.84; 1.82]3,2867,7325%NABérard, 2017 Wemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, sick), 2012 Colvin, 2011 Malm, 2011 60.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.52.71.2840.000Bérard, 2017Wemakor, 2015Ban (Controls unexposed, disease free), 2014Jimenez-Solem (Controls unexposed, sick), 2012Colvin, 2011Malm, 2011

Asymetry test p-value = 0.6002 (by Egger's regression)

slope=-0.1463 (0.6576); intercept=0.8045 (1.4154); t=0.5684; p=0.6002

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6014

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.45[0.86; 2.43]5,1347,14842%NAWemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 unexposed, sick controlsunexposed, sick controls 1.28[0.64; 2.57]82,1901%NABérard, 2017 Jimenez-Solem (Controls unexposed, sick), 2012 20.510.01.0