What is akathisia?
Akathisia is a neuropsychiatric syndrome and movement disorder that makes it difficult to sit or remain still due to an inner restlessness. The name comes from the Greek word “akathemi,” which means “inability to sit.”
Akathisia is associated with the use of certain types of medications, especially antipsychotic (neuroleptic) medications. A few health conditions have also been linked to akathisia, including Parkinson’s disease.
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A person with akathisia experiences an intense sensation of unease or an inner restlessness. This results in a compulsion to move — usually in their lower limbs. In most cases, the movement is repetitive. This uncontrollable need to move can cause extreme distress.
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Healthcare providers classify akathisia in a few ways based on its time of onset and duration, including:
- Acute akathisia: When akathisia develops during the early days of starting a medication, usually antipsychotic medication, or shortly after an increase in dosage, it’s considered acute akathisia. It usually lasts for fewer than six months.
- Chronic akathisia: When akathisia signs and symptoms last for more than six months, it’s considered chronic akathisia. Chronic akathisia can last for several months or even years.
- Tardive akathisia: When akathisia has a delayed onset after starting certain medications or increasing the dosage — usually more than three months — it’s considered tardive akathisia. It’s often associated with tardive dyskinesia.
- Withdrawal akathisia: Akathisia may arise following the reduction of dosage or stopping the use of certain medications. This is considered withdrawal akathisia.
Is akathisia the same as anxiety?
Akathisia and anxiety are different conditions. Akathisia is a movement disorder and anxiety is a type of mental health condition.
While the conditions can have some overlapping symptoms, such as a feeling of restlessness and feeling like you can’t control your thoughts and behaviors, akathisia is mainly a compulsion to constantly move. It doesn’t have fear- or worry-based symptoms. However, this uncontrollable need to move often causes anxiety and distress in people with the condition.
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Unfortunately, akathisia is often misdiagnosed as persistent anxiety and/or agitation.
How common is akathisia?
Akathisia is the most common movement disorder associated with psychotropic 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).
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