Failure to correctly identify akathisia can have catastrophic implications, since increasing severity of akathisia has been linked to the emergence and/or worsening of suicidal ideation, aggression, and violence. As a result, these symptoms are often misdiagnosed as persistent anxiety and/or agitation, and a subsequent dose increase is not only ineffective but often exacerbates antipsychotic- or selective serotonin reuptake inhibitor (SSRIs)-induced akathisia. The clinical presentation of akathisia can be confusing in those patients who often describe vague, non-specific complaints such as nervousness, inner tension, discomfort, restlessness, itching, and/or an inability to relax. Akathisia was subsequently grouped with other antipsychotic-induced movement disorders, including parkinsonism and dystonia, under the umbrella of extrapyramidal signs (EPS).Īkathisia poses a significant challenge in clinical practice. The first report of drug-related akathisia did not appear until 1960, when Kruse described three patients who developed “muscular restlessness” while taking phenothiazines.
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a non-drug related akathisia, in two of his patients. Although most often considered an adverse effect of certain medications, the first description of akathisia in the medical literature appeared in 1901 when the Czech neuropsychiatrist Ladislav Haskovec described a phenomenon he called “inability to sit”, i.e.
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Akathisia is a movement disorder characterized by subjective feelings of internal restlessness or jitteriness with a compelling urge to move leading to the observation of repetitive movements, such as leg crossing, swinging or persistent shifting from one foot to another.