Side-effects scales
Simpson-Angus Scale (SAS)
Main reference: Simpson GM, Angus JWS: A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica 212:11–19, 1970.
Type: Clinician-rated scale.
Main indications: Designed for assessing parkinsonian and related extrapyramidal side effects.
Rating performed by: Clinician or trained mental health professional.
Time period covered by scale: Current clinical condition.
Time required to complete rating: Approx. 10 minutes.
Remarks: Most often used in clinical trials of antipsychotic drugs to assess extrapyramidal symptoms, but also easy to use in clinical settings. Can also be used to assess effectiveness of anticholinergic agents in the treatment of EPS.
(skj)
The Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale
Main reference: Lingjaerde O, Ahlfors UG, Bech P, et al: The UKU Side Effect Rating Scale: a new comprehensive rating scale for psychotropic drugs, and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatrica Scandinavica Suppl 76:1-100, 1987.
Type: Clinician-rated scale.
Main indications: Developed to provide a comprehensive side effect rating scale with well-defined and operationalized items to assess the side effects of psychopharmacological medications.
Rating performed by: Trained mental health professional, on the basis of an interview with the patient and other relevant information from all available sources. In case of discrepancies among the reports, the clinician's observations are given more weight than patient reports.
Time period covered by scale: In general, the rating is made on the basis of a here and now assessment; however, in some cases, it is more appropriate to make the assessment on the basis of the past 3 days (for some symptoms even longer).
Time required to complete rating: 10-30 minutes.
Remarks: Comprehensive, but with only 48 items, relatively easy to use. Designed for use in both clinical trials and routine clinical practice. Rating is independent of whether the symptom is regarded as being drug-induced. Probability of the causal relationship (or lack of it) of each item to the medication in question is indicated in a separate column, which makes it useful for determining subsequent course of action. Subscales can be useful in assessing differential side effect profiles.
(skj)
Abnormal Involuntary Movement Scale (AIMS)
Main reference: Guy W: ECDEU Assessment Manual for Psychopharmacology - Revised (DHEW Publ No ADM 76-338). Rockville, MD, U.S. Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs, 1976, pp 534-537.
Type: Clinician-rated scale.
Main indications: Designed to assess the occurrence of dyskinesias in patients receiving neuroleptic treatment.
Rating performed by: Clinician.
Time period covered by scale: Current clinical condition.
Time required to complete rating: 5-10 minutes.
Remarks: Widely used for assessing tardive dyskinesia. Easy to use, also in routine clinical settings.
(skj)
Extrapyramidal Symptom Rating Scale (ESRS)
Main reference: Chouinard G, Ross-Chouinard A, Annable L, et al.: Extrapyramidal Rating Scale. The Canadian Journal of Neurological Sciences 7:233–239, 1980.
Type: Physician-rated scale of extrapyramidal side effects.
Main indications: Designed to measure extrapyramidal side effects from antipsychotic medication.
Rating performed by: Physician.
Time period covered by scale: Clinical condition at the time of the assessment.
Time required to complete rating: Approximately 10 minutes.
Remarks: Involves six questions about the patient’s subjective experience of extrapyramidal features (slowness, stiffness, and tremor); a standardised procedure for physical examination, and seven rater-assessed items that address parkinsonian features (rigidity and tremor). The instrument may not differentiate effectively between dyskinesia and dystonia, however.
(cmg)
Published on CNSforum 19 Aug 2004