Dégager les points d'accord et de divergence relatifs aux antipsychotiques. Depuis l'apparition des antipsychotiques d'action prolongée (APAP) de 2e génération et vu la fréquence élevée de la non-observance aux antipsychotiques dans les troubles psychotiques, les APAP suscitent une recrudescence d'intérêt dans la littérature psychiatrique. Toutefois, leur utilisation, globalement sous-optimale, connaît de plus des disparités nationales significatives. Dans ce contexte, l'Association des médecins psychiatres du Québec (AMPQ) a demandé un examen des données probantes concernant l'efficacité et la tolérance des APAP, et réclamé une réflexion clinique consensuelle concernant leurs avantages et les obstacles à les prescrire ainsi que des pistes de solution, y compris administratives ou judiciaires.
Méthodes:
Un comité d'experts de 4 universités québécoises, responsable de la rédaction de l'article de synthèse, a été réuni par l'AMPQ. L'esprit de la démarche est de bien outiller les cliniciens quant aux divers aspects liés à l'utilisation des APAP. Le comité a produit une revue qualitative et sélective.
Résultats:
Les taux de prescription des APAP constatés en moyenne au Canada sont autour de 6% et les données sont rares pour le confirmer. On pourrait suggérer un taux entre 15 et 25%.
Conclusion:
Le comité a proposé l'algorithme Québec algorithme antipsychotique à action prolongée (communément appelé QAAPAPLE) issu d'un consensus exprimé par les 4 départements de psychiatrie universitaire.
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