Barnes Akathisia Rating Scale

Symptom Rating Scale (ESRS). Akathisia is commonly monitored by the Barnes Akathisia Scale (BAS). The emergence of dyskinesias (writhing or involuntary movements) could represent the emergence of TD. Monitor for TD at least annually, and if FGAs are used patients should be evaluated at each visit. The most commonly used instrument to measure these symptoms is the Abnormal Involuntary Movement Scale (AIMS). 

It is recommended that neurological side effects be monitored carefully throughout the course of antipsychotic treatment. Rating scales can assist in monitoring for EPS and the involuntary movements seen in tardive dyskinesia. These include the Neurological Rating Scale (Simpson and Angus, 1970), the Barnes Akathisia Scale (Barnes, 1989), and the Abnormal Involuntary Movement Scale ([AIMS] National Institute of Mental Health, 1985). 

Barnes, T. (1989) A rating scale for drug-induced akathisia. Br J Psychiatry 154 672-676. 

In the international, multicenter, double-blind trial of olanzapine, the Simpson-Angus Scale and the Barnes Akathisia Scale were used to monitor treatment-emergent EPS. The acute phase was followed by a 52-week, double-blind, maintenance phase, during which there were significantly lower rates of treatment-emergent Parkinsonism and akathisia (p > 0.001), as well as TD (p < 0.003) in comparison with haloperidol (117). These results suggest that olanzapine has a substantially lower propensity than neuroleptics to evoke EPS, and perhaps TD. 

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