Akathisia
| Akathisia | |
|---|---|
| Other names | Acathisia |
| Common sign of akathisia | |
| Medical specialty | Neurology, psychiatry |
| Symptoms | Feelings of restlessness, inability to stay still, uneasy[1] |
| Complications | Violence or suicidal thoughts[2] |
| Duration | Short- or long-term[2] |
| Causes | Antipsychotics, selective serotonin reuptake inhibitors, metoclopramide, reserpine[2] |
| Diagnostic method | Based on symptoms[2] |
| Differential diagnosis | Anxiety, tic disorders, tardive dyskinesia, dystonia, medication-induced parkinsonism, restless leg syndrome[2][3] |
| Treatment | Reduce or switch antipsychotics, correct iron deficiency,[2] exercise |
| Medication | Diphenhydramine, gabapentin, trazodone, benzodiazepines, benztropine, mirtazapine, beta blockers[4][2] |
| Frequency | Relatively common[4] |
Akathisia (/æ.kə.ˈθɪ.si.ə/ a-kə-THI-see-ə) is a movement disorder.[5] It makes a person feel inner restlessness, usually along with mental distress and/or being unable to sit still.[6][4]
Symptoms
[change | change source]Usually, the legs are most prominently affected.[2] People with akathisia may fidget, rock back and forth, or pace,[7] while some may just have an uneasy feeling in their bodies.[2]
In the most severe cases, people may refuse to take akathisia-causing medications; they might also have worsening psychiatric symptoms, and, because of this, aggression, violence, and/or suicidal thoughts.[2]
Studies suggest that akathisia is also associated with threatening behaviour and physical aggression in mentally disordered patients.[8] However, scientists have not found any systemic link between akathisia and suicidal or homicidal behavior.[9]
Apart from these few low-quality studies, there is another more recent and better quality study (a systematic review from 2021).[9] It concludes akathisia cannot be reliably linked to the presence of suicidal behavior in patients treated with antipsychotic medication.[9]
Causes
[change | change source]Antipsychotic medications, particularly the first generation antipsychotics, are a leading cause.[4][7] Selective serotonin reuptake inhibitors, metoclopramide, and reserpine, may cause akathisia - though any medication that lists agitation as a side effect may trigger it.[2][10] It may also occur upon stopping antipsychotics.[2]
Effects
[change | change source]According to the Cleveland Clinic:[11]
Akathisia is the most common movement disorder associated with [psychiatric] medication, particularly antipsychotic (neuroleptic) medications. Approximately 24% of people who have schizophrenia and are taking medication for it have chronic akathisia. In one study, akathisia rates were 39% in people taking clozapine and 45% among people taking first-generation antipsychotics (FGA).
 | This article contains a translation of Akathisia from es.wikipedia. |
References
[change | change source]- ↑ Salem H, Nagpal C, Pigott T, Teixeira AL (2017). "Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges". Curr Neuropharmacol (Review). 15 (5): 789–798. doi:10.2174/1570159X14666161208153644. PMC 5771055. PMID 27928948.
- 1 2 3 4 5 6 7 8 9 10 11 12 Lohr, JB; Eidt, CA; Abdulrazzaq Alfaraj, A; Soliman, MA (December 2015). "The clinical challenges of akathisia". CNS Spectrums (Review). 20 (Suppl 1): 1–14, quiz 15–6. doi:10.1017/S1092852915000838. PMID 26683525. S2CID 4253429.
- ↑ Kaufman, David Myland; Milstein, Mark J. (2012). Kaufman's Clinical Neurology for Psychiatrists E-Book. Elsevier Health Sciences. p. 429. ISBN 978-1-4557-4004-8.
- 1 2 3 4 Laoutidis, ZG; Luckhaus, C (May 2014). "5-HT2A receptor antagonists for the treatment of neuroleptic-induced akathisia: a systematic review and meta-analysis". The International Journal of Neuropsychopharmacology (Review). 17 (5): 823–32. doi:10.1017/S1461145713001417. PMID 24286228.
- ↑ Poyurovsky M, Weizman A (June 2020). "Treatment of Antipsychotic-Induced Akathisia: Role of Serotonin 5-HT2a Receptor Antagonists". Drugs (Review). 80 (9): 871–882. doi:10.1007/s40265-020-01312-0. PMID 32385739. S2CID 218541032.
- ↑ Forcen, FE; Matsoukas, K; Alici, Y (February 2016). "Antipsychotic-induced akathisia in delirium: A systematic review". Palliative & Supportive Care (Review). 14 (1): 77–84. doi:10.1017/S1478951515000784. PMC 5516628. PMID 26087817.
- 1 2 Thomas, JE; Caballero, J; Harrington, CA (2015). "The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis". Current Neuropharmacology (Review). 13 (5): 681–91. doi:10.2174/1570159x13666150115220221. PMC 4761637. PMID 26467415.
- ↑ Stubbs, J. H.; Hutchins, D. A.; Mountjoy, C. Q. (2000). "Relationship of akathisia to aggressive and self-injurious behaviour: A prevalence study in a UK tertiary referral centre". International Journal of Psychiatry in Clinical Practice. 4 (4): 319–325. doi:10.1080/13651500050517894. ISSN 1365-1501. PMID 24926584. S2CID 26486432.
- 1 2 3 Kalniunas, Arturas; Chakrabarti, Ipsita; Mandalia, Rakhee; Munjiza, Jasna; Pappa, Sofia (3 December 2021). "The Relationship Between Antipsychotic-Induced Akathisia and Suicidal Behaviour: A Systematic Review". Neuropsychiatric Disease and Treatment. 17: 3489–3497. doi:10.2147/NDT.S337785. ISSN 1176-6328. PMC 8651045. PMID 34887662.
- ↑ "MISSD - The Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin - Akathisia Support". missd.co. Retrieved 26 August 2022.
- ↑ "Akathisia: What It Is, Symptoms, Causes & Treatment". Cleveland Clinic. Retrieved 2 October 2025.