Side effects scale/checklist for antipsychotic
medication (SESCAM)
Adapted from Bennett et al (1994)
ASSESSMENT PROCEDURE
Clinician’s assessment:
Observe client in the following way and complete the rating
scale/checklist.
Ensure the client has nothing in the mouth (e.g. chewing gum etc)
and if dentures are worn that there are no problems with fitting.
1) Ask the client to sit down, ensure you are an appropriate distance
away so that you can observe hands and feet as well as face.
Observe facial and oral movements, also any resting tremor or
restlessness of the feet or other parts of the body.
2) Ask client to open the mouth and then protrude the tongue,
observe for any abnormal tongue movements inside the mouth
and when protruding the tongue.
3) Ask client to stand up while you engage them in some
conversation. Observe posture, trunk including hip movements
and any inability to stand still. Ask them to hold their arms out
and observe for any hand tremor.
4) Ask the client to walk several paces, turn and walk back x 2.
Observe arm swing and gait.
Assessment form – to be completed by clinician
Name ……………………………………………….
Date …………………..
D.O.B …………… Sex …………. Diagnosis ……………………………………...
Medications (include all antipsychotics and other medication,
dosages & route)
………………………………………………………………………………………….
………………………………………………………………………………………….
A
1.
2.
3.
4.
5.
B
6
7.
8.
9.
C
10.
11.
12.
13.
14.
Face/Neck/Mouth 0
Unchanging facial
expression
Dribbling
Involuntary
movements of
mouth, lips or
tongue
Looks sleepy
Other (please
specify)
Extremities
Upper: (arm,
hands, fingers)
Regular, resting or
pill rolling tremor
Other (please
specify)
Lower: (legs,
feet)
Tapping of
feet/restlessness
(jogging on the
spot)
Other (please
specify)
Severity
1
2
3
4
0
1
2
3
4
Trunk / posture
0
/ gait
Pelvic gyrations
Rigid, shuffling gait
Reduced arm swing
Slowness and reduced
spontaneity
Other (please specify)
1
2
3
4
Guide for clinician’s completing assessment form:
Severity ratings:
0 = Absent Signs definitely absent during assessment period
1 = Uncertain - Signs maybe present but unsure whether they are
drug-induced side effects or normal variation or
behaviour resulting from abnormal mental or
other cause
2 = Mild Signs just detectable, and in the case of
spontaneous abnormal movements, present only
occasionally
3 = Moderate - Signs moderate, or in the case of abnormal
movements,
pronounced
but
present
only
occasionally, or mild but present most or all of the
time
4 = Severe Signs pronounced and in the case of spontaneous
abnormal movements present most or all of the
time
Additional definition items (numbers relate to numbers on
assessment form):
1
= unchanging facial expression: rigid looking face with little
spontaneous movement
3 = involuntary movements of mouth/lips or tongue: side-to-side
or worm-like rolling and twisting movements of the tongue,
puckering, smacking, pouting of lips and mouth
6 = pill-rolling: circular movements of the thumb against the
index finger
8 = tapping of feet/restlessness: toe tapping, pacing/jogging on
the spot
10 = pelvic gyrations: any writhing/rocking movements, circular or
front to back movements of the pelvis
11 = shuffling gait: shuffling (dragging) of the feet while walking,
knees may be bent
12 = reduced arm swing: arms are fixed or in an unusual position
while walking
Patient’s self-report:
To be completed by the clinician by asking the patient the following
questions and placing a ‘tick’ in the appropriate box.
1.
Do you have any of the following:
Yes
No
If yes, specify problem
a) Dizziness
b) Drowsiness
c) Sexual problems
(ejaculatory,
erectile, libido)
d) Constipation
e) Urinary problems
f) Skin problems
(Rashes,
photosensitivity)
g) Excessive weight
gain
h) Blurred vision
i) Feeling restless
j) Lack of get up and
go
k) Other
2.
Does the medication agree with you?
YES / NO
If no, why (list reasons)
3.
Do you think this is the right medication for you?
Comments
YES / NO