Bupropion (All indications except smoking cessation) updated on 07-01-2025

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.
S18331
R77316
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) 1.04 [0.86;1.24] 765/19,341   223/6,896 988 19,341
ref
S18332
R77327
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 1.34 [1.24;1.44]
excluded (control group)
768/19,426   52,341/2,981,692 53,109 19,426
ref
S12488
R47097
Yeh, 2021 Attention-deficit/hyperactivity disorder (ADHD - at least twice outpatient visits within each year for ICD-9 code: 314) - At 0-10 years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Indications Bupropion: Depression, mood or anxiety disorders Monotherapy: no or not specified Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified 1.59 [0.18;13.69] -/7   -/5,243 - 7
ref
S18370
R77437
Figueroa, 2010 Attention-deficit/hyperactivity disorder (ADHD - primary or secondary diagnosis of ADHD and prescription claims for stimulants) - At 4-5 years old 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) 3.63 [1.20;11.04] 5/114   88/3,532 93 114
ref
Total 3 studies 1.62 [0.65;4.01] 1,081 19,462
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 Suarez (Controls unexposed, discontinuers), 2022Suarez, 2022 1 1.04[0.86; 1.24]98819,34156%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Yeh, 2021Yeh, 2021 1.59[0.18; 13.69]-713%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: unclearROB mesure: moderateROB reporting: critical Figueroa, 2010Figueroa, 2010 3.63[1.20; 11.04]9311431%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 59% 1.62[0.65; 4.01]1,08119,4620.510.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, discontinuers;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 3 Tags Adjustment   - Yes  - Yes 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 3 Indications Bupropion   - Depression, mood or anxiety disorders  - Depression, mood or anxiety disorders 1.59[0.18; 13.87]-7 -NAYeh, 2021 1 Monotherapy   - no or not specified  - no or not specified 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 3.63[1.20; 11.01]93114 -NAFigueroa, 2010 1   - old history of illness/treatment (> ...  - old history of illness/treatment (> 12 months before pregnancy) or not specified 1.59[0.18; 13.87]-7 -NAYeh, 2021 1   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.04[0.87; 1.25]98819,341 -NASuarez (Controls unexposed, discontinuers), 2022 1 All studiesAll studies 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 30.510.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 18332

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.34[1.24; 1.44]53,10919,426 -NASuarez (Controls unexposed, general pop), 2022 1 unexposed, sick controlsunexposed, sick controls 1.62[0.65; 4.01]1,08119,46259%NASuarez (Controls unexposed, discontinuers), 2022 Yeh, 2021 Figueroa, 2010 30.510.01.0