Antipsychotiques à Action Prolongée: Révision de l’algorithme QAAPAPLE

Emmanuel Stip, Amal Abdel-Baki, Marc André Roy, David Bloom, Sylvain Grignon

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: Eight years ago, a committee of experts from 4 Quebec university psychiatry departments has provided the QAAPAPLE algorithm in order to guide clinicians in their use of long-acting antipsychotics (LAAP) for patients with psychotic disorders. Objective: Update the QAAPAPLE algorithm. Methods: Using a qualitative and selective literature review, the experts have focused on several aspects related to the use of LAAP and the relevance of modifying the algorithm: 1) new data on LAAP (including polypharmacy and co-prescription with clozapine, dose frequency/interval); 2) perception and attitude regarding algorithms and evidence; 3) difficulties in implementing algorithms; 4) polypharmacy involving LAAP and co-prescriptions with clozapine; 5) partner patients perspective on the algorithm. Results: Thirteen meta-analysis were published and completed observational studies (including those on national registries), confirming the LAAP benefits. Literature adds specifications about using some drug associations as well as dose frequency and interval. Therefore, scientific advances have been considered to modify the algorithm. Conclusion: Interacting with Quebec psychiatrists, we have examined changes in prescription and literature to better understand the use of algorithm. The committee has updated the QAAPAPLE algorithm to guide clinicians in using LAAP along the path of patients with psychosis as early as the first episode and through different clinical settings (including treatment resistance) in order to have a more flexible and user-friendly treatment.

Original languageEnglish
Pages (from-to)697-707
Number of pages11
JournalCanadian Journal of Psychiatry
Issue number10
Publication statusPublished - Oct 1 2019
Externally publishedYes


  • algorithm
  • antipsychotics
  • depot
  • expert opinion
  • long-acting injection
  • mirror-image study
  • psychosis
  • randomized controlled study
  • recommendations
  • schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health


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