A modification of an earlier rating scale for extrapyramidal system disturbance is described, and evidence for the validity and reliability of the scale is presented. The usefulness of the scale in studies of neuroleptic drugs is discussed. By its application it is possible to quantify extrapyramidal side effects and to separate them into four principal factors.

SUMMARY A controlled study of the relationship between the therapeutic response to a neuroleptic drug and the handwriting changes which it produces is described. Patients whose handwriting had changed as described by Haase improved to a greater extent than those whose handwriting had not changed, but received much larger doses of the drug. Patients treated according to the psychiatrist's judgment received larger doses than those which produced handwriting changes, but in retrospect the optimum dose corresponded closely to the dose producing handwriting changes. These findings are discussed.

Clopenthixol, the thioxanthene analogue of perphenazine, was first studied by Ravn and Rud (8) who reported that this compound possesses neuroleptic properties. This work was confirmed, not only in Europe but also in North America, in early uncontrolled (2,9) as well as controlled studies (3,5,6). Many of these data are summarized in two presentations of symposia (1,4). Although several thioxanthenes (chlorprothixene and thiothixene) are presently on the market, there have remained several questions as to the efficacy and the long-term toxicity of their sister compound, clopenthixol. This study was undertaken to assess clinically the safety and therapeutic efficacy of the drug over a one-year period. SubjectsForty-three male and 17 female patients were selected from the wards of Rockland State Hospital. The mean age for the total group was 45.2 years (standard deviation 8.5 years and range 26 to 61 years). The length of hospitalization ranged from 1.0 to 35.0 years with a mean of 16.7 and a standard deviation of 8.8. DesignThe study lasted fourteen months and the patients were unaware of the specific contents of the medication used, and after a drug-free period of one month they were placed on medication for twelve months and were subsequently followed for a period of one month. DosageClopenthixol was administered in dosages ranging from a minimum of 50 mg per day to a maximum of 200 mg per day. The

We are indebted to our nursing colleagues for their help and are also grateful to Messrs. H. Lundbeck & Co., Copenhagen, for generous supplies of flupenthixol decanoate (Lu. 5â€"I:o).

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