Escitalopram updated on 07-01-2025

ASD (Autism spectrum disorder): Diagnosis/Risk

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.
S18379
R77500
Heuvelman, 2023 Autism spectrum disorder - Validated Read code list among primary care clinical and referral records - Mean age at end of follow-up 10.04 years, range 4–22 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.93 [0.46;1.89] -/546   -/16,330 - 546
ref
S10007
R46830
Ames, 2021 Autism spectrum disorder (ASD): diagnostic criteria on the Autism Diagnostic Observation Schedule and the full ASD diagnostic criteria on the ADI-R or one of three alternative criteria on the ADI-R (age NOS). 3 months (or more) before pregnancy or during pregnancy excluded case control unexposed, disease free Adjustment: No Monotherapy: no or not specified 2.09 [0.95;4.58] C
excluded (exposition period)
17/27   1,350/3,011 1,367 27
ref
S7639
R46831
Viktorin - Citalopram or escitalopram (Controls unexposed, NOS), 2017 Autism spectrum disorder (ICD10- F84.0, F84.1, F84.2, F84.3, F84.4, F84.5, F84.8, or F84.9) at 7-8 years during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.71 [1.16;2.51]
excluded (control group)
-/1,097   1,524/172,646 - 1,097
ref
S7821
R46832
Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 Autism spectrum disorder (ICD10- F84.0, F84.1, F84.2, F84.3, F84.4, F84.5, F84.8, or F84.9) at 7-8 years during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.47 [0.92;2.35] 19/639   -/- - 639
ref
Total 2 studies 1.27 [0.83;1.93] 0 1,185
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 Heuvelman, 2023Heuvelman, 2023 0.93[0.46; 1.89]-54633%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: criticalROB mesure: criticalROB reporting: low Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017Viktorin - Citalopram or esci..., 2017 1 1.47[0.92; 2.35]-63967%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 11% 1.27[0.83; 1.93]-1,1850.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.27[0.83; 1.93]-1,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.27[0.83; 1.93]-1,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 2 Tags Adjustment   - Yes  - Yes 1.27[0.83; 1.93]-1,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 2 Monotherapy   - no or not specified  - no or not specified 1.27[0.83; 1.93]-1,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.93[0.46; 1.89]-546 -NAHeuvelman, 2023 1   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.47[0.92; 2.35]-639 -NAViktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 1 All studiesAll studies 1.27[0.83; 1.93]-1,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 20.25.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 7639

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.71[1.16; 2.52]1,5151,097 -NAViktorin - Citalopram or escitalopram (Controls unexposed, NOS), 2017 1 unexposed, sick controlsunexposed, sick controls 1.27[0.83; 1.93]101,18511%NAHeuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Halvorsen - Citalopram/escitalopram (Autism s ...Halvorsen - Citalopram/escitalopram (Autism spectrum disorder _ Cohort studies) 1.68[1.17; 2.42]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 1.27[0.83; 1.93]11%1,185----Heuvelman, 2023 Viktorin - Citalopram or escitalopram (Controls unexposed, sick), 2017 20.510.01.0