13 Nov 2025 TI Blog Update: November 2025
We are excited to announce that today, we posted Therapeutics Letter 159, a detailed re-evaluation of how the single enantiomer escitalopram (Cipralex, Lexapro) compares with its parent drug, citalopram (Celexa). In 2002 we first reported that no randomized clinical trial favoured escitalopram. Our new systematic review shows there is still no reason to believe that escitalopram is better or safer than its parent. Dr. Aaron Tejani will give a presentation on this topic at the upcoming 2025 annual TI Course: Bringing Best Evidence to Clinicians, scheduled to take place on November 28-29, 2025 as a virtual/online event (details below). If you ever attended an event sponsored by a pharmaceutical manufacturer, you may recall how messages from Key Opinion Leaders are subtly (or not so subtly?) tailored to advance commercial interests over those of patients or the public. Should non-academic clinicians care? Given the effects of population aging and the rising costs of new health technologies and drugs, we have an increasingly important role to preserve affordability of health care. A future Therapeutics Letter will examine other examples of how “evergreening” drugs can fool us into unnecessarily expensive prescribing. We hope that our Letters, produced after meticulous critical appraisal and background research, help clinicians and patients to practice rationally and save precious money.
Registration for the 2025 annual TI Course: Bringing Best Evidence to Clinicians is now above 90%. Only a few spots remain available and we expect the event to be SOLD OUT within a few days. The course is happening November 28-29, 2025 and will be offered as a virtual/online event. This year’s program is one of our most interesting. It features a keynote presentation on treatment of pain given by internationally renowned expert, Dr. David Juurlink, a general internist and clinical pharmacologist/toxicologist at Sunnybrook Health Sciences Centre and the Hospital for Sick Children.
Since 2016, TI academic staff and invited presenters have undergone a “peer review” in advance of any presentation. We find this improves the clarity of presentations, and helps presenters stay on time. This process allowed me a sneak preview of Dr. Allyson Harrison’s keynote presentation, “ADHD & Other Disability Diagnoses: Seven Sins of Clinicians,” that opens our course on Friday, November 28th at 12:30-13:30 h Pacific Standard Time. Dr. Harrison is Associate Professor at Queens University in Kingston, Ontario, and a research neuropsychologist in its Regional Resource and Assessment Centre for students with disabilities. I found her discussion of how clinicians approach the diagnosis and documentation of disability in ADHD and other conditions both timely and exceptionally interesting. Two experienced family physicians agreed that Dr. Harrison raises issues of immense practical importance to anyone working in primary care in North America. If your patients ask you to complete assessments and forms to accommodate disabilities, or for disability tax credits or long-term disability, you will not want to miss this challenging but very practical presentation.
But Dr. Harrison’s talk is only the first taste of our annual course. Other distinguished invited speakers include Dr. Iliana Lega from the University of Toronto who will speak about menopause and Dr. Jamie Falk from the University of Manitoba who will speak about heart attacks. TI faculty will also cover a wide range of topics: GLP-1RA/SGLT2 inhibitors in type 2 diabetes, enantiomers vs racemic drugs, the role of relative and absolute measures of efficacy in comparing treatment benefits and harms, drugs that cause edema, and highlights from the TI Portrait program. The scope of information is broad, practical, and often controversial, thus appealing to professionals in family practice, internal medicine, and pharmacy.
This, like all TI events, does not receive any sponsorship from the device or pharmaceutical industry. The TI Annual Course meets the certification criteria of the College of Family Physicians of Canada and has been certified by UBC CPD for up to 6.5 Mainpro+® Certified Activity credits.
Read more: https://ti.ubc.ca/annual-course-2025
Register: https://ubc.zoom.us/meeting/register/TzhapUTlRKmbC3pxFiOVlw
The TI Portrait program was recently recognized with the UBC Innovation Award for CME/CPD. If you are a family physician or nurse practitioner in British Columbia we invite you to join over 1,100 of your colleagues who are already benefitting from this innovative quality improvement program. Twelve topics have already been released and more will be added in the coming months. Participants are receiving personalized, completely confidential information that can help improve their prescribing practice to serve patients better. In addition, participants in the Portrait program who attend a related 1-hour webinar can now claim both Mainpro+ Certified Activity credits, as well as much coveted Mainpro+ Certified Assessment Activity credits. Registration is simple and free: BC family physicians and nurse practitioners can sign up to access confidential prescribing Portraits via our convenient and secure online portal.
Log in to view your Portraits and/or related materials if you’re already registered, or sign up if you haven’t already.
Questions? Email the TI Portrait team at portrait@ti.ubc.ca We welcome your feedback.
Even more important, we hope that if you teach or mentor students in medicine, pharmacy, and nursing, you will encourage your students to subscribe for our Therapeutics Letters and notices of webinars and educational events. The people of British Columbia support our work, so that we remain unconflicted. Subscribing is free to anyone, anywhere.
I hope you can find something of interest among the various things we are offering. And we always welcome your comments and suggestions.
Thomas L. Perry MD, FRCPC
Editor, Therapeutics Letter
Therapeutics Initiative
University of British Columbia, Vancouver
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