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Akathisia – Symptoms, Causes, Treatment

Written by Dr.Mary

What is Akathisia?

Akathisia is a condition or a manifestation from long-term intake of certain drugs. This condition should not be confused with restless leg syndrome as akathisia has a general feel of inner restlessness unlike with RLS. Accordingly, the meaning of akathisia is literally the inability to sit. This is basically coined after the manifestation of the condition which is restlessness, making the person unable to stay still or sit still.

The condition can be classified according to scale or degree of akathisia. The Barnes Akathisia scale will measure the degree of akathisia suffered by the affected. There are rating scales in order to assess the condition and shall also provide objective information from the patient and some subjective information, which is usually the complaint of the client.

Akathisia Symptoms

As observed, the patient shall have the urge to move restlessly, for it shall be more difficult in his part when he or she is immobile. Here are the following manifestations of akathisia:

  • Feeling of restlessness
  • Increased anxiety that can lead to panic
  • Pacing
  • Altered sleeping pattern

Akathisia Causes

Akathisia is generally caused by taking certain drugs, meaning the disorder is an adverse reaction from a medical remedy. In the old times, this condition is most prominent; for certain drugs such as the antipsychotic medications have side effects which include akathisia. In the advent of medicine, newer drugs were made to provide lesser adverse and side effects. But here are medications or drugs that place a person at risk for suffering akathisia:


Haldol or the generic drug haloperidol, risperidone and aripiprazole (Ablify). These antipsychotic drugs are non-sedating and provide akathisia as a side effect.

SSRIs or selective serotonin reuptake inhibitors

A known drug from this class is Prozac. This class of drug can induce or place a person at risk for akathisia after taking this in a long time.


Those such as the tricyclics and trazodone can cause for akathisia.


A drug indicated for patients with Parkinson’s disease. This drug is believed to cause akathisia.


These can result to akathisia most especially the agent such as cyproheptadine and diphenhydramine.


Alcohol withdrawal

After some time off from alcohol and with the abrupt stoppage of drinking can cause for akathisia. One should avoid abrupt decrease in alcohol intake, instead gradual decrease is much recommended so that the body has time to adjust with the alteration.

Opioid withdrawal and barbiturates withdrawal

These drugs are controlled and should not be abused as these can provide bad effects to the body such as addiction. Once the practice is stopped abruptly, withdrawal symptoms may develop and shall include akathisia.

Akathisia Treatment

Treatment for akathisia is aimed in knowing first the root cause then it’s time to target the treatment of the condition. Here are the tips in order to avoid and treat akathisia:

Know the causative agent or underlying condition that may have caused akathisia. When it has been known that the condition was caused by the sudden withdrawal of an agent, we need to slowly reduce the dosage of these drugs. There should be proper medical assistance, especially when controlled or illegal drugs are constituted by the condition.


The first-line drug for akathisia is propranolol. This medication is a sympatholytic non-selective beta blocker, usually indicated for patients with increased blood pressure. This is also noted to be of use for patients with antipsychotic-induced akathisia. Benzodiazepines are also recommended for the treatment of akathisia. This would include clonazepam as a regularly prescribed drug.

Vitamin supplementation

Providing the client with vitamin B6 has presented a good and promising help in treating neuroleptic-induced akathisia. Vitamin B6 is known to be also great for our neurons.


This can be attained with avoiding the abuse of opioids and barbiturates. We can avoid the hassle in the withdrawal symptoms after taking or abusing such chemicals. It sometimes cannot be avoided that others are prescribed with antipsychotic agents. Advice for those taking the drugs; they need to ask for good drug classes that shall not provide an adverse effect of akathisia. Consulting the doctor’s advice is a must. Another is taking of the prescribed medications in a complied and religious manner can place one person away from harm.

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