Topiramate (Epilepsy) updated on 04-22-2025

ADHD (Attention deficit hyperactivity 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.
S19464
R82993
Straub (Controls exposed to LTG) (Topiramate) (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) exposed to other treatment, sick excluded Adjustment: No 1.92 [1.38;2.69] C
excluded (control group)
56/961   102/3,273 158 961
ref
S19474
R83129
Straub (Controls unexposed, sick) (Topiramate) (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 [0.81;1.48] 56/961   366/8,887 422 961
ref
S17438
R73270
Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 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, sick Adjustment: Yes Partial overlapping 1.01 [0.38;2.71] -/71   929/10,769 - 71
ref
S17260
R72264
Madley-Dowd_UK (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median follow up 5.41 (3.59-8.40) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.63 [0.04;10.74] C
excluded (control group)
0/43   14/791 14 43
ref
S17255
R72265
Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median follow up 5.41 (3.59-8.40) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.23 [0.07;20.41] C 0/43   38/4,075 38 43
ref
S15875
R65447
Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 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 exposed to other treatment, sick excluded Adjustment: No 3.19 [1.85;5.50] C
excluded (control group)
16/290   95/5,288 111 290
ref
S15876
R65456
Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 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 2.38 [1.40;4.06] 16/290   528/22,203 544 290
ref
S7307
R48831
Bromley (Topiramate), 2016 Maladaptive behavior: Attention (BASC) (5-9 years old) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No extrapolated (cont. endpoint) 1.00 [0.43;2.31] -/27   -/55 - 27
ref
Total 5 studies 1.33 [0.88;1.99] 1,004 1,392
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 (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026Straub, 2026 1 1.09[0.81; 1.48]42296141%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024Madley-Dowd_SE, 2024 2 1.01[0.38; 2.71]-7113%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024Madley-Dowd_UK, 2024 3 1.23[0.07; 20.41]38432%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 4 2.38[1.40; 4.06]54429028%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Bromley (Topiramate), 2016Bromley, 2016 5 1.00[0.43; 2.31]-2716%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 42% 1.33[0.88; 1.99]1,0041,3920.55.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick) (Topiramate) (Epilepsy; 2: Topiramate) (Controls unexposed, sick; 3: Topiramate) (Controls unexposed, sick) (Epilepsy; 4: Topiramate) (Epilepsy) (Controls unexposed, sick; 5: Topiramate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.33[0.88; 1.99]1,0041,39242%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Topiramate), 2016 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.33[0.88; 1.99]1,0041,39242%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Topiramate), 2016 5 Tags Adjustment   - No  - No 1.02[0.45; 2.28]38700%NAMadley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Bromley (Topiramate), 2016 2   - Yes  - Yes 1.41[0.80; 2.51]9661,32269%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 3 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 1.00[0.43; 2.32]-27 -NABromley (Topiramate), 2016 1 Partial overlappingPartial overlapping 1.01[0.38; 2.70]-71 -NAMadley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 1 All studiesAll studies 1.33[0.88; 1.99]1,0041,39242%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Topiramate), 2016 50.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.43.61.7180.000Straub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023Bromley (Topiramate), 2016

Asymetry test p-value = 0.8706 (by Egger's regression)

slope=0.1857 (0.3407); intercept=0.2190 (1.2355); t=0.1773; p=0.8706

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 15875, 17260, 19464

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.33[0.88; 1.99]1,9241,39242%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sick) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Topiramate), 2016 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.27[1.45; 3.56]2831,29437%NAStraub (Controls exposed to LTG) (Topiramate) (Epilepsy), 2026 Madley-Dowd_UK (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023 30.510.01.0