Akathisia - A Brief Review - SMJ

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ish Medical Journal

Editorials/Comments

October 2001

AKATHISIA - A BRIEF REVIEW

D E

The Orchard Clinic

Royal Edinburgh Hospital

Morningside Terrace

Edinburgh

SMJ 2001;46: 133-134

" Akathisia is a common and unpleasant side effect of many psychotropic

medications. Junior doctors are often slow to recognise it with

consequences for the patient which include reduced compliance,

exacerbation of psychotic symptoms and an increased risk of suicide and

violence. The word akathisia comes from the Greek meaning literally " not

to sit' and was initially used by Haskovec in 19021 to refer to restless

patients with hysteria and neurasthenia. Akathisia is a relatively

common side effect of antipsychotic medication, although other drugs

including antidepressants, metoclopramide, some calcium channel

blockers, dopamine agonists, amphetamine and buspirone have all been

shown to cause it. The symptoms consist of objective and subjective

components. Subjectively there are symptoms of dysphoria including

tension, panic, irritability and impatience2 and objectively there are

movements usually taking the form of shuffling of feet while sitting and

pacing or rocking while standing. Fidgety leg movements may occur while

lying down.3 The differential diagnosis includes agitation secondary to

psychotic symptoms, the restless legs syndrome, anxiety, drug withdrawal

states and a number of neurological disorders. "

http://www.smj.org.uk/1001/aka1001.htm

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Mayo Clinic in Rochester

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s Hopkins Medicine

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