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
G25.71 – Drug induced akathisia
230333002 – Drug-induced akathisia
Differential Diagnosis & Pitfalls
- Anxiety (drug-induced anxiety or generalized anxiety disorder)
- Depressive disorders
- Drug-induced psychosis
- Restless legs syndrome – usually only present when a patient tries to rest
- Peripheral neuropathy – patients may have dysesthesias of the skin with relief from physical activity such as walking, rubbing, or moving
- Alcohol or opiate withdrawal
- Stimulant overdose – amphetamines, caffeine
- Generalized pruritus – patients will describe an urge to scratch along with movement
Drug Reaction Data