Topiramate (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.
S19379
R82267
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
S19372
R82171
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
S17420
R73135
Madley-Dowd_SE (Topiramate) (Controls exposed to LTG) (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 exposed to other treatment, sick excluded Adjustment: Yes Partial overlapping 0.93 [0.55;1.57]
excluded (control group)
15/264   243/5,035 258 264
ref
S17421
R73141
Madley-Dowd_SE (Topiramate) (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 0.80 [0.48;1.33] 15/264   147,608/2,651,210 147,623 264
ref
S17422
R73147
Madley-Dowd_SE (Topiramate) (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 0.51 [0.19;1.35]
excluded (control group)
-/-   -/- - -
ref
S17285
R72339
Madley-Dowd_UK (Topiramate) (Controls exposed to LTG) (Mixed indications), 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: Yes 0.43 [0.06;3.43]
excluded (control group)
-/154   14/939 - 154
ref
S17270
R72296
Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 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 (general population or NOS) Adjustment: Yes 0.71 [0.10;5.32] -/154   4,794/514,066 - 154
ref
S17278
R72321
Madley-Dowd_UK (Topiramate) (Controls unexposed, sibling) (Mixed indications), 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) sibling excluded Adjustment: Yes 0.25 [0.02;2.67]
excluded (control group)
-/-   -/- - -
ref
S17468
R73415
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
S17469
R73425
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
Total 4 studies 1.21 [0.73;2.01] 148,589 1,669
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]42296137%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_SE, 2024 2 0.80[0.48; 1.33]147,62326429%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK, 2024 3 0.71[0.10; 5.32]-1546%ROB confusion: seriousROB 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]54429029%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 68% 1.21[0.73; 2.01]148,5891,6690.25.01.0ROB: 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, general pop) (Mixed indications; 3: Topiramate) (Controls unexposed, general pop) (Mixed indications; 4: Topiramate) (Epilepsy) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.21[0.73; 2.01]148,5891,66968%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.79[0.48; 1.30]147,6234180%NAMadley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 2 unexposed, sickunexposed, sick 1.56[0.73; 3.34]9661,25184%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 2 Tags Adjustment   - Yes  - Yes 1.21[0.73; 2.01]148,5891,66968%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 4 Partial overlappingPartial overlapping 0.80[0.48; 1.33]147,623264 -NAMadley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 1 All studiesAll studies 1.21[0.73; 2.01]148,5891,66968%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.42.61.2170.000Straub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026Madley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 17468, 17420, 17422, 17285, 17278, 19379

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.79[0.48; 1.30]152,4084180%NAMadley-Dowd_SE (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, general pop) (Mixed indications), 2024 2 unexposed, sick controlsunexposed, sick controls 1.56[0.73; 3.34]9661,25184%NAStraub (Controls unexposed, sick) (Topiramate) (Epilepsy), 2026 Dreier (Topiramate) (Epilepsy) (Controls unexposed, sick), 2023 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.61[0.88; 2.96]5321,66976%NAStraub (Controls exposed to LTG) (Topiramate) (Epilepsy), 2026 Madley-Dowd_SE (Topiramate) (Controls exposed to LTG) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls exposed to LTG) (Mixed indications), 2024 Dreier (Topiramate) (Epilepsy) (Controls exposed to LTG), 2023 4 siblingssiblings Out of scale0.46[0.19; 1.15]--0%NAMadley-Dowd_SE (Topiramate) (Controls unexposed, sibling) (Mixed indications), 2024 Madley-Dowd_UK (Topiramate) (Controls unexposed, sibling) (Mixed indications), 2024 20.510.01.0