2001; Lacro et al. 2002; Lambert et al. 2004; Wong et al. 2011]. Questions refer to problems that ‘may’ be related to medication. This is because it is often difficult for the patient to be certain of what causes symptoms. Causality is best explored by the clinician when the patient is interviewed, supported by physical examination and blood tests when appropriate,

including assessment of adherence with treatments. In developing the final SMARTS checklist, the faculty took account of feedback on a draft version of the checklist that was discussed in a second meeting of 65 practising Inhibitors,research,lifescience,medical clinicians from the EMEA region. At this meeting 65% of attendees indicated they would use the draft Inhibitors,research,lifescience,medical tool if it

were available. The choice of 11 side effects to include in the questionnaire was based on the clinical experience of the faculty as well as the existing literature [Hamer and Haddad, 2007; Haddad and Sharma 2007; Lean and Pajonk, 2003]. Together the 11 questions encompass extrapyramidal symptoms (parkinsonism, akathisia), sexual dysfunction, symptoms of hyperprolactinaemia, postural Inhibitors,research,lifescience,medical hypotension, sedation, appetite and weight change, gastrointestinal side effects, urinary symptoms and affective side effects (Table 1). The latter item was included as antipsychotic-induced dysphoria is a distressing though often neglected side effect [Voruganti and Awad, 2004]. Several of the items on the checklist can be caused by different mechanisms, for example, urinary symptoms (‘difficulty inhibitors passing water or passing water very frequently’; item 9) could include urinary hesitancy, an antimuscarinic effect Inhibitors,research,lifescience,medical of an antipsychotic, and urinary frequency, a symptom of type 2 diabetes caused by an antipsychotic. The

11 chosen side effects represented a shortlist of those that appear to be commonest, most clinically relevant and most troublesome for patients and their carers. A complete inventory of all possible side effects would be impractical, but enquiry about additional side effects should be considered during clinical interviews guided by answers to the 12 SMARTS Inhibitors,research,lifescience,medical questions as well as to the medications the patient is prescribed. Early feedback on the SMARTS checklist Following its development, the final SMARTS checklist was presented at a third meeting that was attended by 50 practising psychiatrists from across the EMEA region. Their feedback was very positive. of Most respondents reported that the checklist covered relevant side effects that they encountered in their clinical work, that they would use it in their clinical practice and that the language was appropriate for patients. Subsequently, a number of attendees expressed an interest in translating the document into their own country’s language for further dissemination. To date, the SMARTS checklist has been translated into Italian and Turkish.