Journal ArticleDOI
First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: A meta‐analysis of epidemiological studies
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TLDR
A meta-analysis of maternal first trimester paroxetine use and the prevalence of congenital defects found little evidence of publication bias or overall statistical heterogeneity and only weak evidence of associations with some study characteristics.Abstract:
BACKGROUND: Several studies have evaluated maternal first trimester paroxetine use and the prevalence of congenital defects, particularly cardiac defects. To synthesize current epidemiologic information, a meta-analysis was conducted. METHODS: A systematic literature search was conducted for original research published from January 1, 1992, through September 30, 2008. Results were extracted using predefined criteria, and authors were contacted for additional information when necessary. Compiled results were evaluated for funnel plot asymmetry, heterogeneity, and study characteristic associations. Where appropriate, fixed-effect summary estimates were calculated and sensitivity analyses performed. RESULTS: Twenty reports (11 including results for aggregated congenital and combined cardiac defects, six for aggregated congenital defects only, and three for combined cardiac defects only) met prespecified inclusion criteria. There was little evidence of funnel plot asymmetry or overall heterogeneity. Summary estimates were produced for combined cardiac defects (prevalence odds ratio [POR], 1.46; 95% confidence interval [CI], 1.17–1.82) and aggregated congenital defects (POR, 1.24; 95% CI, 1.08–1.43) and first trimester paroxetine use. Some study characteristics may be associated with differential POR estimates for paroxetine and either combined cardiac or aggregated congenital defects. CONCLUSIONS: This meta-analysis found little evidence of publication bias or overall statistical heterogeneity and only weak evidence of associations with some study characteristics. Although subject to limitations, the summary estimate indicates an increased prevalence of combined cardiac defects with first trimester paroxetine use. The summary estimate also indicates an increased prevalence of aggregated congenital defects with paroxetine; however, this association may be explained, in part, by the increased prevalence of combined cardiac defects. Birth Defects Research (Part A), 2010. © 2009 Wiley-Liss, Inc.read more
Citations
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Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders
Martin A Katzman,Pierre Bleau,Pierre Blier,Pratap Chokka,Kevin Kjernisted,Michael Van Ameringen +5 more
TL;DR: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.
Journal ArticleDOI
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly.
Glenda MacQueen,Benicio N. Frey,Zahinoor Ismail,Natalia Jaworska,Meir Steiner,Ryan J. Van Lieshout,Sidney H. Kennedy,Raymond W. Lam,Roumen Milev,Sagar V. Parikh,Arun V. Ravindran +10 more
TL;DR: Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.
Journal ArticleDOI
Antidepressant Use in Pregnancy and the Risk of Cardiac Defects
Krista F. Huybrechts,Kristin Palmsten,Jerry Avorn,Lee S. Cohen,Lewis B. Holmes,Jessica M. Franklin,Helen Mogun,Raisa Levin,Mary K. Kowal,Soko Setoguchi,Sonia Hernandez-Diaz +10 more
TL;DR: The results of this large, population-based cohort study suggested no substantial increase in the risk of cardiac malformations attributable to antidepressant use during the first trimester.
Journal ArticleDOI
Congenital heart disease: current knowledge about causes and inheritance
TL;DR: Recurrence risks vary between different types of non‐syndromal CHD with multifactorial inheritance, and can be as high as 10% when two or more siblings are affected, and the recurrence risk increases if a parent rather than a sibling is affected, particularly when the affected parent is the mother.
Journal ArticleDOI
Selective serotonin reuptake inhibitors and risk for major congenital anomalies.
TL;DR: Fluoxetine use is associated with an increased risk of isolated ventricular septal defects and paroxetines is associatedWith right ventricular outflow tract defects and the absolute risk for these specific cardiac anomalies is small but should guide clinicians not to consider fluoxettine or paroxETine the first option when prescribing selective serotonin reuptake inhibitors to women planning pregnancy.
References
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Journal ArticleDOI
Bias in meta-analysis detected by a simple, graphical test
TL;DR: Funnel plots, plots of the trials' effect estimates against sample size, are skewed and asymmetrical in the presence of publication bias and other biases Funnel plot asymmetry, measured by regression analysis, predicts discordance of results when meta-analyses are compared with single large trials.
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TL;DR: In this paper, an adjusted rank correlation test is proposed as a technique for identifying publication bias in a meta-analysis, and its operating characteristics are evaluated via simulations, and the test statistic is a direct statistical analogue of the popular funnel-graph.
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Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.
Sue Duval,Richard L. Tweedie +1 more
TL;DR: In this paper, a rank-based data augmentation technique is proposed for estimating the number of missing studies that might exist in a meta-analysis and the effect that these studies might have had on its outcome.
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What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data
TL;DR: Many routinely used summary methods provide widely ranging estimates when applied to sparse data with high imbalance between the size of the studies' arms, including Mantel-Haenszel summary estimates using the alternative continuity correction factors, which gave the least biased results for all group size imbalances.