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Meta-analysis - maternal and paternal antidepressant use and the risk of neurodevelopmental disorders in offspring
A new meta-analysis involving 37 studies with almost 650,000 pregnancies exposed to antidepressants and 25,000,000 unexposed pregnancies has been published. Before adjusting for confounders, there was a small association between antidepressant use and the development of ADHD or autism in offspring, but this became non-significant once known confounders (e.g. maternal mental health issues) were taken into account. Please see the attached trial for full details.
Acetazolamide shortage - CPhA Guidance
The Canadian Society of Healthcare-Systems Pharmacy, Canadian Paediatric Society, and Canadian Ophthalmological Society have released a guidance document on the current acetazolamide shortage. Please see the attached document for full details.
Imipenem, cilastatin, and relebactam - Recarbrio - IV Monograph - updated May 2026
Mood Stabilizers in Hemodialysis - Lithium, Valproate, and Lamotrigine - Psychopharmacology Institute
The Psychopharmacology Institute has published an excellent article on mood stabilizers, including lithium, valproate, and lamotrigine, in hemodialysis. It provides a practical overview on the use of each. Please see the attached document for full details.
Phentolamine - IV Monograph - updated June 2026
Ebola Disease
Please see the attached FAQ as it pertains to the recent outbreak of Ebola disease. For any readers out there, "Crisis in the Red Zone" and "The Hot Zone", both by Richard Preston, are both excellent books discussing the origins and past outbreaks of Ebola disease.
Clozapine rechallenge after neutropenia
This large cohort study from the UK and Ireland looked at those who had previously registered in the Central Non-Rechallenge Database after using clozapine, and assessed the proportion and incidence rates of patients who were successfully rechallenged with clozapine. A failure was considered anyone who had re-registration on this database within 6 months of their recallenge. Of the ~4700 patients in the database, ~1300 (27%) were rechallenged on clozapine, 435 of which (34%) of which met the study criteria. Only 7% of patients (n = 27) were re-registered in the database with a further neutropenic episode within 6 months of rechallenge, though 20% of patients (n=87) had less than 6 months of follow-up after rechallenge. Increased age, male sex, and a higher baseline neutrophil were factors associated with rechallenge failure. Please see their full study for details.
Important Alert on Amoxi-Clav Stability
Sunnybrook has been conducting stability testing on repackaged oral drugs, particularly those known to have stability concerns. As part of that testing, amoxicillin-clavulanic acid tablets from low-density polyethylene unit-dose packaging have been found to have undetectable amounts of clavulanic acid. This degradation is most likely due to moisture, though the time period over which this degradation occurred has not yet been established. These results have been validated and confirmed. Given these results, Sunnybrook has replaced all hospital stock. Fresh original stock bottles have been packaged into manual Class A Aclar Amber Blister Blocks. Given the absence of data, an arbitrary, conservative Beyond-Use Date of 30 days has been chosen for this low-moisture-permeability packaging. See the table in the attached document for recommendations on other package types. Further testing using various packaging types will begin next week and is expected to take 13 weeks to complete. Results will be made available once finalized. Please see the attached document for additional details.