Citalopram updated on 07-01-2025

Nervous system anomalies

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.
S7437
R21927		 Bérard, 2017 Nervous system malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.28 [0.55;2.93] -/584   -/14,847 - 584
ref
S5884
R14732		 Ban (Controls unexposed, disease free), 2014 Nervous system malformations 1st trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.18 [0.37;3.71] -/1,946   465/325,294 - 1,946
ref
S10215
R37417		 De Jonge, 2013 Central nervous system anomalies 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.98 [0.12;32.41] C 0/35   208/29,396 208 35
ref
S6014
R15491		 Jimenez-Solem (Controls unexposed, NOS), 2012 Malformations of the nervous system 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.84 [0.21;3.37] 2/1,606   -/843,797 - 1,606
ref
S7179
R20206		 Colvin, 2011 Nervous system defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.27 [0.41;3.96] -/775   289/94,561 - 775
ref
S6241
R16480		 Malm, 2011 Central nervous system 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.20 [0.66;2.19] -/2,799   -/628,607 - 2,799
ref
Total 6 studies 1.20 [0.81;1.78] 208 7,745
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 Bérard, 2017Bérard, 2017 1.28[0.55; 2.93]-58422%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, disease free), 2014Ban, 2014 1 1.18[0.37; 3.71]-1,94612%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate De Jonge, 2013De Jonge, 2013 1.98[0.12; 32.41]208352%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: critical Jimenez-Solem (Controls unexposed, NOS), 2012Jimenez-Solem, 2012 2 0.84[0.21; 3.37]-1,6068%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Colvin, 2011Colvin, 2011 1.27[0.41; 3.96]-77512%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Malm, 2011Malm, 2011 1.20[0.66; 2.19]-2,79944%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 0% 1.20[0.81; 1.78]2087,7450.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, disease free; 2: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.19[0.80; 1.77]-7,7100%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 case control studiescase control studies 1.98[0.12; 32.41]20835 -NADe Jonge, 2013 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.18[0.75; 1.85]2087,1610%NABan (Controls unexposed, disease free), 2014 De Jonge, 2013 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 unexposed, sickunexposed, sick 1.28[0.55; 2.95]-584 -NABérard, 2017 1 Tags Adjustment   - No  - No 1.35[0.47; 3.87]2088100%NADe Jonge, 2013 Colvin, 2011 2   - Yes  - Yes 1.18[0.77; 1.80]-6,9350%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 4 Monotherapy   - no or not specified  - no or not specified 1.23[0.68; 2.21]2082,8340%NADe Jonge, 2013 Malm, 2011 2   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.28[0.55; 2.95]-584 -NABérard, 2017 1   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.11[0.55; 2.24]-4,3270%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.28[0.55; 2.95]-584 -NABérard, 2017 1 All studiesAll studies 1.20[0.81; 1.78]2087,7450%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 De Jonge, 2013 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 60.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.43.51.7110.000Bérard, 2017Ban (Controls unexposed, disease free), 2014De Jonge, 2013Jimenez-Solem (Controls unexposed, NOS), 2012Colvin, 2011Malm, 2011

Asymetry test p-value = 0.8456 (by Egger's regression)

slope=0.1515 (0.1634); intercept=0.0687 (0.3305); t=0.2077; p=0.8456

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.18[0.75; 1.85]9447,1610%NABan (Controls unexposed, disease free), 2014 De Jonge, 2013 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 unexposed, sick controlsunexposed, sick controls 1.28[0.55; 2.95]-584 -NABérard, 2017 10.510.01.0