Carbamazepine (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.
S19377
R82251
Straub (Controls exposed to LTG) (Carbamazepine) (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 2.31 [1.75;3.05] C
excluded (control group)
107/1,548   102/3,273 209 1,548
ref
S19368
R82107
Straub (Controls unexposed, sick) (Carbamazepine) (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 1.13 [0.89;1.43] 107/1,548   366/8,887 473 1,548
ref
S17405
R72980
Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Median follow up 15.8 (9.52-21.08) years old during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes Partial overlapping 1.16 [1.02;1.33]
excluded (control group)
257/2,427   243/5,035 500 2,427
ref
S17406
R72984
Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Median follow up 15.8 (9.52-21.08) years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Partial overlapping 1.05 [0.92;1.19] 257/2,427   147,608/2,651,210 147,865 2,427
ref
S17407
R72988
Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sibling) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Median follow up 15.8 (9.52-21.08) years old during pregnancy (anytime or not specified) population based cohort retrospective sibling excluded Adjustment: Yes Partial overlapping 0.98 [0.68;1.41]
excluded (control group)
-/-   -/- - -
ref
S17280
R72327
Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median CBZ 9.17 (5.31-12.54) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: Yes 0.61 [0.35;1.07]
excluded (control group)
13/603   14/939 27 603
ref
S17264
R72275
Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median CBZ 9.17 (5.31-12.54) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 1.51 [0.87;2.61] 13/603   4,794/514,066 4,807 603
ref
S17272
R72318
Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sibling) (Mixed indications), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median CBZ 9.17 (5.31-12.54) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) sibling excluded Adjustment: Yes 0.86 [0.26;2.91]
excluded (control group)
-/-   -/- - -
ref
S15231
R62555
Dreier (Carbamazepine) (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 1.89 [1.41;2.53] C
excluded (control group)
89/2,665   95/5,288 184 2,665
ref
S15235
R62609
Dreier (Carbamazepine) (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 1.05 [0.81;1.37] 89/2,665   528/22,203 617 2,665
ref
S9723
R34605
Huber-Mollema (Carbamazepine), 2019 Diagnosis of ADHD throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.95 [0.18;5.12] C 2/37   5/88 7 37
ref
S9696
R34508
Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.82 [0.07;46.28] C
excluded (control group)
1/50   0/30 1 50
ref
S9699
R34524
Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 13.21 [0.53;329.15] C
excluded (control group)
1/50   0/214 1 50
ref
S9702
R34540
Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Attention deficit hyperactivity disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.58 [0.06;40.13] C 1/50   0/26 1 50
ref
S9711
R34559
Cohen (Carbamazepine), 2013 Children with either ADHD inattentive OR combined types > 1 SD (from the Attention Problems and Hyperactivity scales of the BASC) (Both Parent and Teacher) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.96 [0.22;4.25] C 4/32   4/31 8 32
ref
Total 7 studies 1.08 [0.97;1.19] 153,778 7,362
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) (Carbamazepine) (Epilepsy), 2026Straub, 2026 1 1.13[0.89; 1.43]4731,54818%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_SE, 2024 2 1.05[0.92; 1.19]147,8652,42762%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK, 2024 3 1.51[0.87; 2.61]4,8076033%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 4 1.05[0.81; 1.37]6172,66515%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huber-Mollema (Carbamazepine), 2019Huber-Mollema, 2019 5 0.95[0.18; 5.12]7370%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 6 1.58[0.06; 40.13]1500%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine), 2013Cohen, 2013 7 0.96[0.22; 4.25]8320%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: low Total (7 studies) I2 = 0% 1.08[0.97; 1.19]153,7787,3620.25.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick) (Carbamazepine) (Epilepsy; 2: Carbamazepine) (Controls unexposed, general pop) (Mixed indications; 3: Carbamazepine) (Controls unexposed, general pop) (Mixed indications; 4: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 5: Carbamazepine; 6: Carbamazepine) (Controls unexposed, sick; 7: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.08[0.97; 1.19]153,7787,3620%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 7 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.14[0.85; 1.53]152,6723,03037%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 2 unexposed, sickunexposed, sick 1.09[0.92; 1.30]1,0914,2630%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 3 exposed to other treatment, sickexposed to other treatment, sick 0.96[0.31; 2.92]15690%NAHuber-Mollema (Carbamazepine), 2019 Cohen (Carbamazepine), 2013 2 Tags Adjustment   - No  - No 1.01[0.35; 2.89]161190%NAHuber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 3   - Yes  - Yes 1.08[0.97; 1.19]153,7627,2430%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 4 Partial overlappingPartial overlapping 1.05[0.92; 1.19]147,8652,427 -NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 1 All studiesAll studies 1.08[0.97; 1.19]153,7787,3620%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2013 70.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.01.9810.000Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Madley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Huber-Mollema (Carbamazepine), 2019Bromley (Carbamazepine) (Controls unexposed, sick), 2013Cohen (Carbamazepine), 2013

Asymetry test p-value = 0.3878 (by Egger's regression)

slope=0.0440 (0.0435); intercept=0.2997 (0.3169); t=0.9456; p=0.3878

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9696, 9699, 15231, 17405, 17407, 17280, 17272, 19377

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.25[0.79; 1.96]152,6733,08049%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, general pop) (Mixed indications), 2024 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 3 unexposed, sick controlsunexposed, sick controls 1.09[0.92; 1.30]1,0914,2630%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.34[0.90; 2.00]9367,36282%NAStraub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls exposed to LTG) (Mixed indications), 2024 Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Huber-Mollema (Carbamazepine), 2019 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Cohen (Carbamazepine), 2013 7 siblingssiblings 0.97[0.68; 1.37]--0%NAMadley-Dowd_SE (Carbamazepine) (Controls unexposed, sibling) (Mixed indications), 2024 Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sibling) (Mixed indications), 2024 20.510.01.0