Akathisia

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]

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]

Symptoms

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

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

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.