Frequency, Intensity, Burden of Side Effects Rating (FIBSER) scale


The Frequency, Intensity, Burden of Side Effects Rating (FIBSER) scale was designed by Dr. Stephen Wisniewski for use in the U.S. STAR*D effectiveness study. It is a 3-item scale to assess side effects from antidepressant treatment.

To use the FIBSER in measurement-based care, clinicians should consider item 3 (Burden).

  • If the score is 0 to 2 (None to Mild interference with activities), no change in medication is needed.
  • If the score is 3-4 (Moderate to Marked interference with activites), the side effects need to be addressed (i.e., change in dose, side effect antidote, etc).
  • If the score is 5-6 (Severe interference with activities or Unable to Function), the dose needs to be decreased or the medication needs to be switched.

With Dr. Wisniewski’s permission, we revised and simplified the language of the FIBSER to make it easier to use.

The revised FIBSER is free to use by clinicians and for academic studies funded via nonprofit organizations. Please contact Dr. Lam ( for permission to us in for-profit sponsored research.

The FIBSER is included in our MoodFx web app. Check it out here.


Download the FIBSER

FIBSER revised, 2018

FIBSER revised, 2018 – Chinese version (Chinese version, thanks to Dr. Tao Yang and Dr. Lu Yang)



Wisniewski SR, Rush AJ, Balasubramani GK, et al, Self-rated global measure of the frequency, intensity and burden of side effects.
J Psychiatr Prac 2006;12:71-9.