Akathisia

Akathisia is a movement disorder that manifests as a feeling of inner restlessness and the inability to stay still. It's a common side effect of certain medications, particularly antipsychotics.

Artist's rendition of Akathisia

Clinical Presentation

Individuals with akathisia experience a compelling urge to move, often accompanied by uncomfortable sensations in the legs. This can manifest as rocking while standing or sitting, lifting the feet as if marching on the spot, crossing and uncrossing the legs, and pacing around.

Causes

The most common cause of akathisia is medication, especially antipsychotic drugs. Other drugs, including certain antiemetics and antidepressants, can also cause akathisia. In some cases, akathisia can be a symptom of Parkinson's disease or a side effect of its treatment.

Diagnosis

Akathisia is usually diagnosed based on the patient's symptoms and history, especially the use of drugs associated with this condition. Various rating scales, such as the Barnes Akathisia Rating Scale (BARS), can be used to quantify the severity of symptoms.

Management

Management strategies for akathisia include reducing the dose or discontinuing the offending drug, if possible. Other treatments include the use of drugs such as benzodiazepines, beta blockers, or anticholinergics to manage symptoms. In severe cases, hospitalization may be required.

Prognosis

With appropriate management, symptoms of akathisia can often be significantly reduced or eliminated. However, if left untreated, this condition can lead to distress, anxiety, and depression.

Epidemiology

The incidence of akathisia varies significantly depending on the population studied and the specific medications used. It's particularly common among individuals receiving antipsychotic medication, with studies reporting incidences ranging from 20% to 75%.

Research Directions

Despite significant advances in understanding the underlying mechanisms of akathisia, much remains unknown about this condition. Current research efforts are focused on identifying more effective treatment strategies and understanding the biological basis of drug-induced akathisia.

See Also

• Dystonia
• Tardive dyskinesia
• Parkinson's disease
• Extrapyramidal symptoms

References

Akathisia Resources
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