Citalopram updated on 07-01-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk

id	Study   Auto Heuvelman, 2023Olstad - (Es)citalopram (Controls unexposed, disease free), 2023Olstad - (Es)citalopram (Controls unexposed, sick), 2023Suarez (Controls unexposed, discontinuers), 2022Suarez (Controls unexposed, general pop), 2022	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18376 R77487	Heuvelman, 2023	Attention deficit hyperactivity disorder -Medical codes or therapy records that indicated that the child had been prescribed ADHD medication - 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 [0.61;1.40]	-/4,620   -/16,330	-	4,620		ref
S14998 R61415	Olstad - (Es)citalopram (Controls unexposed, disease free), 2023	Attention deficit hyperactivity disorder (ADHD) diagnosis - ICD-10: F90 - Until 5 years old	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, disease free excluded	Adjustment: No Matched Monotherapy: no or not specified	2.71 [1.27;5.80] C excluded (control group)	23/306   10/344	33	306		ref
S14999 R61416	Olstad - (Es)citalopram (Controls unexposed, sick), 2023	Attention deficit hyperactivity disorder (ADHD) diagnosis - ICD-10: F90 - Until 5 years old	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, sick	Adjustment: No Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy)	1.31 [0.69;2.48] C	23/306   18/308	41	306		ref
S18255 R76867	Suarez (Controls unexposed, discontinuers), 2022	Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age	2nd and/or 3rd trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy)	1.03 [0.81;1.29]	373/13,797   183/7,605	556	13,797		ref
S18256 R76868	Suarez (Controls unexposed, general pop), 2022	Attention Deficit Hyperactivity Disorder - ≥ 2 dates with ICD-9 Dx 314.xx or ≥ 2 dispensings or 1 diagnosis and 1 dispensing - At ≥ 2 years of age	2nd and/or 3rd trimester	retrospective cohort (claims database)	unexposed (general population or NOS) excluded	Adjustment: Yes Monotherapy: no or not specified	1.23 [1.10;1.37] excluded (control group)	374/13,818   50,747/2,920,559	51,121	13,818		ref
					Total	3 studies	1.03 [0.85;1.25]		597	18,723
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 18256, 14998