Extrapyramidal Symptoms Rating Scale

Clozapine has been evaluated in an open study in seven patients (mean age 29 years mean dose 428 mg/day) with chronic exacerbated schizophrenia and severe tardive dyskinesia (92). Extrapyramidal Symptoms Rating Scale scores fell by 83% after 3 years and 88% after 5 years. None of the patients had adverse effects related to clozapine their weight did not change significantly and their serum glucose, cholesterol, and triglyceride concentrations remained within the reference ranges. 

Palmer et al. (1999) focused on extrapyramidal symptoms (EPS) rather than TD and found that severity of EPS correlated with the severity of neuropsychological deficits, especially in the areas of learning and motor skills. Krausz et al. (1999) found a similar correlation between EPS and cognitive deficits on a self-rating scale. They believed the deficits were sufficient to cause potential difficulty with insight and everyday life skills. 

In a 6-week open study of risperidone (mean dosage 4.7 mg/day) in combination with mood-stabilizing treatments (usually lithium, carbamazepine, or valproate) for the treatment of schizoaffective disorder in 102 patients, 95 of whom completed the trial, at week 4 most patients had improved symptom severity and 9.3% were completely symptom-free (35). There were no statistically significant differences between baseline and week 4 in the severity of extrapyramidal symptoms, as measured by the UKU Side-Effect Rating Scale subscale for neurological adverse effects other adverse effects included depressive symptoms (n = 13), exacerbation of mania ( n = 5), drowsiness (n = 3), and impotence (n = 2). 

The efficacy and tolerability of risperidone, yokukansan and fluvoxamine for the treatment of behavioural and psychological symptoms of dementia was studied in a blinded, randomised trial [239 ]. Compared with the other treatments, risperidone was significantly associated with constipation, muscle rigidity and extrapyramidal symptoms (based on extrapyramidal rating-scale scores) no significant changes in BP or heart rate were observed with any of the treatments. 

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