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

All congenital malformations (majors, minors, majors and minors, or unspecified)

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.
S12927
R49071		 Anderson, 2020 Major birth defects 1st trimester case control unexposed (general population or NOS) Adjustment: No Indications Bupropion: Any or not mentioned Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.24 [0.89;1.73] C 149/194   30,481/41,914 30,630 194
ref
S11786
R43363		 Ozturk, 2016 Major congenital defects at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Indications Bupropion: Any or not mentioned Monotherapy: no or not specified 69.29 [1.20;4014.93] C 0/1   3/246 3 1
ref
S11749
R43191		 Einarson, 2009 Major malformations 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Indications Bupropion: Any or not mentioned Monotherapy: no or not specified 0.16 [0.01;2.60] C 0/113   25/928 25 113
ref
S12933
R51607		 Cole, 2007 Major malformations 1st trimester retrospective cohort (claims database) exposed to other treatment, sick Adjustment: Yes Indications Bupropion: Any or not mentioned Monotherapy: no or not specified 0.95 [0.62;1.45] 28/1,213   110/4,743 138 1,213
ref
S13087
R51605		 Chun-Fai-Chan (Controls exposed to other antidepressants), 2005 Major malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No Indications Bupropion: Depression, mood or anxiety disorders Matched Monotherapy: no or not specified 0.26 [0.01;6.47] C
excluded (control group) 		0/72   1/57 1 72
ref
S13088
R51606		 Chun-Fai-Chan (Controls unexposed, NOS), 2005 Major malformations at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Indications Bupropion: Any or not mentioned Matched Monotherapy: no or not specified 0.24 [0.01;4.98] C 0/105   2/126 2 105
ref
Total 5 studies 1.05 [0.60;1.82] 30,798 1,626
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 Anderson, 2020Anderson, 2020 1.24[0.89; 1.73]30,63019448%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Ozturk, 2016Ozturk, 2016 69.29[1.20; 4014.93]312%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Einarson, 2009Einarson, 2009 0.16[0.01; 2.60]251134%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Cole, 2007Cole, 2007 0.95[0.62; 1.45]1381,21343%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Chun-Fai-Chan (Controls unexposed, NOS), 2005Chun-Fai-Chan, 2005 1 0.24[0.01; 4.98]21053%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Total (5 studies) I2 = 49% 1.05[0.60; 1.82]30,7981,6260.0500.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.87[0.15; 5.00]1681,43255%NAOzturk, 2016 Einarson, 2009 Cole, 2007 Chun-Fai-Chan (Controls unexposed, NOS), 2005 4 case control studiescase control studies 1.24[0.89; 1.73]30,630194 -NAAnderson, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.99[0.17; 5.89]30,66041357%NAAnderson, 2020 Ozturk, 2016 Einarson, 2009 Chun-Fai-Chan (Controls unexposed, NOS), 2005 4 exposed to other treatment, sickexposed to other treatment, sick 0.95[0.62; 1.45]1381,213 -NACole, 2007 1 Tags Adjustment   - No  - No 0.99[0.17; 5.89]30,66041357%NAAnderson, 2020 Ozturk, 2016 Einarson, 2009 Chun-Fai-Chan (Controls unexposed, NOS), 2005 4   - Yes  - Yes 0.95[0.62; 1.45]1381,213 -NACole, 2007 1 Indications Bupropion   - Any or not mentioned  - Any or not mentioned 1.05[0.60; 1.82]30,7981,62649%NAAnderson, 2020 Ozturk, 2016 Einarson, 2009 Cole, 2007 Chun-Fai-Chan (Controls unexposed, NOS), 2005 5 MatchedMatched 0.24[0.01; 4.98]2105 -NAChun-Fai-Chan (Controls unexposed, NOS), 2005 1 Monotherapy   - no or not specified  - no or not specified 0.87[0.15; 5.00]1681,43255%NAOzturk, 2016 Einarson, 2009 Cole, 2007 Chun-Fai-Chan (Controls unexposed, NOS), 2005 4   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.24[0.89; 1.73]30,630194 -NAAnderson, 2020 1 All studiesAll studies 1.05[0.60; 1.82]30,7981,62649%NAAnderson, 2020 Ozturk, 2016 Einarson, 2009 Cole, 2007 Chun-Fai-Chan (Controls unexposed, NOS), 2005 50.01000.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.15.12.4850.000Anderson, 2020Ozturk, 2016Einarson, 2009Cole, 2007Chun-Fai-Chan (Controls unexposed, NOS), 2005

Asymetry test p-value = 0.8789 (by Egger's regression)

slope=0.1407 (0.3112); intercept=-0.1739 (1.0492); t=0.1658; p=0.8789

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 13087

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.99[0.17; 5.89]30,66041357%NAAnderson, 2020 Ozturk, 2016 Einarson, 2009 Chun-Fai-Chan (Controls unexposed, NOS), 2005 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.93[0.61; 1.42]1391,2850%NACole, 2007 Chun-Fai-Chan (Controls exposed to other antidepressants), 2005 20.510.01.0