Barnes Akathisia Rating Scale (BARS)

The Barnes Akathisia Rating Scale (BARS) is a brief, 4-item scale used to assess the severity of akathisia in patients taking antipsychotic medications.1
Description: The Barnes Akathisia Rating Scale (BARS) is a brief, 4-item scale used to assess the severity of akathisia in patients taking antipsychotic medications.1
Disease States: General
Validated Uses: Medication Side Effects
Administration Method: Self-report, Clinician-report
Time to administer: 10 minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description:

The BARS is the most common scale to assess drug-induced akathisia.1 Akathisia is a movement side effect associated primarily with antipsychotic medications.2 Akathisia is characterized by a subjective sense of restlessness and mental unease, and objective signs of motor features such as the inability to sit still.5 

The BARS is a 4-item scale measuring 2 components of akathisia: Subjective feelings and objective motor activity. The severity of akathisia is determined based on3

  • Observation of the patients’ movement features by the clinician (scored 0 to 3) 

  • Patient report of feelings of internal restlessness (scored 0 to 3) 

  • Patient report of mental distress/discomfort/unease related to restlessness (scored 0 to 3) 

  • Global clinical assessment of the overall severity based on the combined results of the objective and subjective components (scored 0 to 5) 

A global assessment score of 2 or higher is defined as the diagnostic threshold for akathisia.5 

For the objective motor activity item of the scale, the clinician should observe patients’ movements both while they are seated and while they are standing and engaged in neutral conversations or activities, for at least 2 minutes each.3

Scale Validity: Inter-rater reliability was determined by measuring Cohen’s x from duplicate testing of 42 chronic in-patients receiving antipsychotic medication. Reliability was 0.74 for objective items, 0.83 for subjective items, 0.90 for distress items, and 0.96 for global items.3
Alternative Versions: None.
Cited Limitations: The presence and severity of the akathisia movements can be underestimated in a brief, formal interview setting. The movements may be suppressed or less severe when the patient is engaged in an interview or aware that they are being examined. It is recommended that the interviewer stands with the patient and engages them in casual conversations.2


Supporting references for the filters are as follows: Validated Uses: Medication side effects1,2; Administration Method: Combination of clinician-report and self-report3; Time to administer: 10 minutes4; Commonly used in: Clinical Trials & Research, Clinical Practice.2

This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient.   

ABBV-US-01517-MC, Version 1.0
Approved 02/2024
AbbVie Medical Affairs


  1. Lohr JB, Eidt CA, Abdulrazzaq Alfaraj A, Soliman MA. The clinical challenges of akathisia. CNS Spectr. 2015;20 Suppl 1:1-16. doi:10.1017/S1092852915000838  
  2. ​Barnes TR. The Barnes Akathisia Rating Scale – revisited. J Psychopharmacol. 2003;17(4):365-370. doi:10.1177/0269881103174013  
  3. Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry. 1989;154:672-676. doi:10.1192/bjp.154.5.672 
  4. Suzuki T. Which rating scales are regarded as 'the standard' in clinical trials for schizophrenia? A critical review. Psychopharmacol Bull. 2011;44(1):18-31.  
  5. Pringsheim T, Gardner D, Addington D, et al. The assessment and treatment of antipsychotic-induced akathisia. Can J Psychiatry. 2018;63(11):719-729. doi:10.1177/0706743718760288 

Welcome To NP Psych Navigator

This website is intended for healthcare professionals inside the United States.
Please confirm that you are a healthcare professional inside the US.

No, I am not US Healthcare professional

You are now leaving NP Psych Navigator

Links to sites outside of NP Psych Navigator are provided as a resource to the viewer. AbbVie Inc accepts no responsibility for the content of non-AbbVie linked sites.

Redirect to:

Please to bookmark content