What is Akathisia?

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  • Last Modified Date: 19 October 2019
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Akathisa, also spelled acathisia, is a medical term used to describe “inner restlessness,” often in response to taking certain types of medications designed to treat psychiatric conditions. It may also occur in people with certain disorders like Parkinson’s disease, or be the result of certain conditions like the manic or hypomanic phase of bipolar I and II. Often, akathisia is linked to use of antipsychotics, but recent studies also link it to use of some anti-depressants of the SSRI class (selective serotonin reuptake inhibitors). Some doctors suggest that akathisia resulting from SSRI use may be creating greater suicidality among patients who experience it.


Inner restlessness can be interpreted in a lot of ways. Some people feel mild or moderately anxious or tense. Akathisia often expresses itself as a feeling that you just can’t sit still, and severe cases can mean a person must move around, or becomes extremely weepy, has panic attacks, can’t sleep, and may not even be able to lie down to get to sleep. If you can consider a time when you were extremely anxious, worried or restless about things, imagine feeling this for an extended period of time. If you’ve ever paced a hospital floor waiting for bad or good news about a sick or ailing loved one, or have been so nervous about something you couldn’t sleep, you’d have a good sense of what akathisia feels like. The main difference for people with the condition and those who experience the occasional bout of extreme worry or restlessness is that this condition is relentless and unremitting.

Studies on SSRIs suggest that some people develop the condition when given SSRIs. In this state, people are more likely to kill themselves or to try than they are when they are in a depressed state. They feel they must do something to make the restlessness stop, because there isn’t a single second of rest from it.

Unfortunately, some medications, especially medications used to treat conditions like schizophrenia, dissociative disorder or the delusions associated with manic depression, may worsen akathisia. A host of drugs called neuroleptic antipsychotics list this as a common side effect. These include medications like haloperidol, clozapine, trazadone, perphenazine, and chlorpromazine, to name just a few. If you are prescribed a neuroleptic antipsychotic drug, or have begun taking an SSRI, do ask your doctor which symptoms you should look for, so you can quickly get help if you begin to experience them.

Not all people get this condition from SSRIs or neuroleptic antipsychotics, but many do develop these symptoms, particularly when taking antipsychotics. This can sometimes be disastrous without the right doctor, because akathisia may be misdiagnosed as a greater manifestation of psychotic symptoms. Instead of stopping a medication creating the problem, more of the same medication may be prescribed, which will greatly worsen the condition.

The main treatment for akathisia is to stop or lower the levels of the drug suspected of creating the problem. Other treatments that can help are medication with things like certain tranquilizers or even antihistamines. With more knowledge about this difficult condition, which in its worse manifestations is torturous to endure, it is hoped that patients encountering it will get appropriate and immediate treatment. If you find yourself experiencing these symptoms, do contact your doctor or psychiatrist immediately and ask if akathisia may be prompting these feelings.


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Post 4

Oh boy do I have a lot to say about this. I had akathisia for six months after just one injection of flupenthixol (lowest dose). Looking back, I don't know how I survived. It was, by miles, the worst thing I have ever experienced in my life. It changed the way I see the world.

Neither psychiatrists nor regular doctors would acknowledge that I had it, saying it was "psychosomatic" and "worsening of my normal anxiety" despite the fact I was pumping my arms up and down 24/7 and lost several pounds in weight from pacing. For me, it was the intense need to be in constant motion that drove me insane. I made a suicide attempt for the

first time and ended up back on the psychiatric ward. I was tried on procyclidine and propranolol but neither worked and I just had to ride it out for half a year.

My boyfriend got quite fed up, and said that nothing could possibly be this bad, and that I was maybe self absorbed for constantly crying about it, but six months later he experienced mild akathisia from aripriprizole, which eased after two weeks as he immediately discontinued, but he found himself apologizing profusely to me for doubting my level of pain. I feel I have never quite returned to normal although it's no longer in my daily life. I would go as far as to say, that akathisia inducing drugs would be the most effective criminal deterrent ever. I have heard several ex heroine users describe heroine withdrawal as "a walk in the park compared to akathisia". Seriously.

The worst part is that it is one hundred percent impossible to explain to someone who has not had it; you feel so alone. Something this important needs urgent awareness raised so that it can be recognized and treated. Although I have been on 12 different psychiatric medications before encountering akathisia, I am now absolutely petrified of any drug at all. I have read from other sufferers that it is possible to get it from general anesthesia and even some antibiotics. I am now deemed as non compliant for not wanting to try any more psychiatric drugs, and so my psychotherapy was greatly delayed. The only thing that will console me for this great loss in my life, will be if I can spread the message so that it is less likely to happen to other people.

Post 3

Dangerous advice at the end. Why would you consult your psychiatrist about this? They were probably the one who caused it in the first place. At best, they might give you a benzo, to which you'll probably wind up getting addicted to. Go see a real doctor.

Post 2

I got this from paroxetine, after using it for just eight days. It never went away, and has now been over three months. My body is completely destroyed from the constant walking and being jittery and insomnia. I cannot take this anymore and I am seriously suicidal. And I'm only 27 years old.

I was in a very good shape before this happened. Now all my muscles are gone and I'm sick all the time. every place is hurting, but yet I cannot stay still for a minute. There are no drugs that help with this. What a horrific way to die.

Post 1

I had it when I was taking Lexapro. Only took it for three days but couldn't stand it anymore. I didn't get any sleep, and seems like all of the muscles in my body trembled -- especially the back of my neck and back of my head. Had extreme urge to just move. Needless to say, this caused more anxiety and depression. It caused enough anxiety to make me think that if this doesn't pass, I don't know if I want to live. That's how bad it gets. SSRI's are *not* for me.

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