AIMS Scale

Monitor for tardive dyskinesia in patients on antipsychotics or other dopamine-blocking agents. Perform at baseline and every 6–12 months.

Indication

Monitor for tardive dyskinesia in patients on antipsychotics or other dopamine-blocking agents. Perform at baseline and every 6–12 months.

Criteria

id: item1; label: 1. Muscles of facial expression; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item2; label: 2. Lips and perioral area; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item3; label: 3. Jaw; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item4; label: 4. Tongue; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item5; label: 5. Upper extremities (arms, wrists, hands, fingers); type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item6; label: 6. Lower extremities (legs, knees, ankles, toes); type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: item7; label: 7. Trunk (neck, shoulders, hips); type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: global; label: 8. Global judgment of severity; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: incapacitation; label: 9. Incapacitation due to movements; type: options; options: value: 0; label: 0 None; value: 1; label: 1 Minimal; value: 2; label: 2 Mild; value: 3; label: 3 Moderate; value: 4; label: 4 Severe
id: awareness; label: 10. Patient awareness of movements; type: options; options: value: 0; label: 0 Unaware; value: 1; label: 1 Aware, no distress; value: 2; label: 2 Aware, mild distress; value: 3; label: 3 Aware, moderate distress; value: 4; label: 4 Aware, severe distress
id: dental; label: Current dental problems; type: yesno; points: 1
id: dentures; label: Usually wears dentures; type: yesno; points: 1

Clinical pearls

Tardive dyskinesia is irreversible in ~50% of cases — prevention via minimal antipsychotic dose and duration is critical
Clozapine and quetiapine have the lowest TD risk
Valbenazine is the preferred FDA-approved treatment for TD
Perform AIMS before starting antipsychotics (baseline) and every 6 months thereafter

Source and review

Guy W. ECDEU Assessment Manual 1976; NIMH. Last reviewed: 2025-01-01