Akathisia

Akathisia
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Inner restlessness, inability to stay still
Complications	Anxiety, depression, suicide
Onset	Minutes to weeks after starting or increasing dose of antipsychotic medication
Duration	Variable, can persist for weeks to months
Types	N/A
Causes	Antipsychotic medications, SSRIs, other medications
Risks	High doses of antipsychotics, rapid dose escalation, history of akathisia
Diagnosis	Clinical evaluation
Differential diagnosis	Restless legs syndrome, tardive dyskinesia, anxiety disorder
Prevention	N/A
Treatment	Reducing or discontinuing the causative medication, beta blockers, benzodiazepines
Medication	Propranolol, lorazepam, mirtazapine
Prognosis	N/A
Frequency	Common in patients on antipsychotics
Deaths	N/A

Akathisia is a movement disorder that manifests as a feeling of inner restlessness and the inability to stay still. It's a common side effect of certain medications, particularly antipsychotics.<ref>Miller, CH, 
 The spectrum of akathisia, 
 Journal of Neuropsychiatry and Clinical Neurosciences, 
 1994,
 Vol. 6(Issue: 1),
 pp. 100-109,
 DOI: 10.1176/jnp.6.1.100,</ref>

Artist's rendition of Akathisia

Clinical Presentation

Individuals with akathisia experience a compelling urge to move, often accompanied by uncomfortable sensations in the legs. This can manifest as rocking while standing or sitting, lifting the feet as if marching on the spot, crossing and uncrossing the legs, and pacing around.<ref>Barnes, TRE,

 A Rating Scale for Drug-Induced Akathisia, 
 British Journal of Psychiatry, 
 1989,
 Vol. 154(Issue: 5),
 pp. 672-676,
 DOI: 10.1192/bjp.154.5.672,</ref>

Causes

The most common cause of akathisia is medication, especially antipsychotic drugs. Other drugs, including certain antiemetics and antidepressants, can also cause akathisia. In some cases, akathisia can be a symptom of Parkinson's disease or a side effect of its treatment.

Diagnosis

Akathisia is usually diagnosed based on the patient's symptoms and history, especially the use of drugs associated with this condition. Various rating scales, such as the Barnes Akathisia Rating Scale (BARS), can be used to quantify the severity of symptoms.<ref>Sachdev, P,

 The development of the concept of akathisia: a historical overview, 
 Schizophrenia Research, 
 1995,
 Vol. 14(Issue: 2),
 pp. 117-28,
 DOI: 10.1016/0920-9964(94)00056-4,</ref>

Management

Management strategies for akathisia include reducing the dose or discontinuing the offending drug, if possible. Other treatments include the use of drugs such as benzodiazepines, beta blockers, or anticholinergics to manage symptoms. In severe cases, hospitalization may be required.

Prognosis

With appropriate management, symptoms of akathisia can often be significantly reduced or eliminated. However, if left untreated, this condition can lead to distress, anxiety, and depression.<ref>Hansen, L,

 Extrapyramidal symptoms and signs in first-episode, drug-naive patients with schizophrenia, 
 Acta Psychiatrica Scandinavica, 
 2005,
 Vol. 111(Issue: 1),
 pp. 67-73,
 DOI: 10.1111/j.1600-0447.2004.00423.x,</ref>

Epidemiology

The incidence of akathisia varies significantly depending on the population studied and the specific medications used. It's particularly common among individuals receiving antipsychotic medication, with studies reporting incidences ranging from 20% to 75%.<ref>Kane, JM,

 Tardive dyskinesia rates with atypical antipsychotics in adults: prevalence and incidence, 
 Journal of Clinical Psychiatry, 
 2001,
 Vol. 62(Issue: Suppl 4),
 pp. 21-31,</ref>

Research Directions

Despite significant advances in understanding the underlying mechanisms of akathisia, much remains unknown about this condition. Current research efforts are focused on identifying more effective treatment strategies and understanding the biological basis of drug-induced akathisia.

See Also

• Dystonia
• Tardive dyskinesia
• Parkinson's disease
• Extrapyramidal symptoms

References

<references/>

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