What is Akathisia?

Akathisia refers to the peculiar state of mental and motor restlessness that cause a state of “inner agitation.” A person suffering from Akathisia is acutely aware of the strong desire to be in a restless state of constant motion, but he or she cannot voluntarily suppress the desire. In its milder form, the patient may just appear anxious, and a physician may mistakenly diagnose it as “non-specific anxiety” if he or she is not aware of the specific clinical features of akasthisia.

In its more severe form, akathisia is associated with severe dysphoria, “prominent depressive symptoms superimposed on manic psychosis” (Merck Manual definition). Accute akathisia involves the patient feeling very fidgety with a strong urge to repeatedly change body position (e.g., the sitting patient may constantly shift his position in a chair, or make constant rocking motions, or constantly cross and uncross his legs, or constantly swing his legs to-and-fro; the standing patient may constantly shift from one foot to the other foot, and he or she may even frantically pace about the room). The marked distress associated with akathisia can lead to impulsive suicide attempts. Akathisia is commonly associated with antipsychotic medications, as well as various antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs) like Paxil.