Akathisia is a common extrapyramidal symptom that is strongly associated with antipsychotic treatment. It also occurs with antiemetic and antidepressant drugs and may result in medication noncompliance. Akathisia is difficult to recognize and is often undiagnosed, despite its prevalence as an adverse effect.

Akathisia presents as motor restlessness caused by a constant urge to move. This urge is relieved during movement. Affected patients may be observed pacing and may be unable to remain standing or sitting still. The condition may also present with disturbed behavior involving feelings of fear, dread, agitation, aggression, anger, violence, or suicidal ideation, and it may result in insomnia. Less severe cases may involve only a subjective feeling of restlessness with no observable movement abnormalities.

The condition may appear soon after medication introduction or medication increase, as a result of long-term use, or during withdrawal. It may occur more often in women. Akathisia typically does not persist once identified and treated.

Related topic: Drug-induced movement disorders