Akathisia

akathisia

Subclass of	psychomotor agitation
Health specialty	neurology

Akathisia (/æ.kə.ˈθɪ.si.ə/ a-kə-THI-see-ə) be a movement disorderwey be characterized by a subjective feeling of inner restlessness wey be accompanied by mental distress den/anaa an inability to sit still. Usually, de legs most be prominently affected. Those wey be affected fi fidget, rock back den forth, anaa pace, while sam fi just get an uneasy feeling insyd dema bodies. De most severe cases fi result in poor adherence to medications, exacerbation of psychiatric symptoms, den, secof dis, aggression, violence, den/anaa suicidal thoughts. Akathisia sanso be associated plus threatening behaviour den physical aggression insyd mentally disordered patients. However, de attempts to find potential links between akathisia den emerging suicidal anaa homicidal behaviour no be systematic wey be mostly based on a limited number of case reports den small case series. Apart from dese few low-quality studies, der be anoda more recent den better quality study (a systematic review from 2021) wey dey conclude akathisia no fi be reliably linked to de presence of suicidal behavior insyd patients dem treat plus antipsychotic medication.

Antipsychotic medication, particularly de first generation antipsychotics, be a leading cause. Oda agents commonly responsible for dis side-effect sanso fi include selective serotonin reuptake inhibitors, metoclopramide, den reserpine, though any medication wey dey list agitation as a side effect fi trigger am. E sanso fi occur upon stopping antipsychotics. De underlying mechanism be believed to involve dopamine. Wen antidepressants be de cause, der be no agreement on de distinction between activation syndrome den akathisia. Akathisia often be included as a component of activation syndrome. However, de two phenomena no be de same since de former, namely antipsychotic-induced akathisia, dey suggest a known neuroreceptor mechanism (e.g., dopamine-receptor blockade). Diagnosis be based on de symptoms. E dey differ from restless leg syndrome insyd dat akathisia no be associated plus sleeping. However, despite a lack of historical association between restless leg syndrome den akathisia, dis no dey guarantee say de two conditions no dey share symptoms insyd individual cases.

If akathisia be caused by an antipsychotic, treatment fi include switching to an antipsychotic plus a lower risk of de condition. De antidepressant mirtazapine, although paradoxically associate plus de development of akathisia insyd sam individuals, demonstrate benefit, as have diphenhydramine, trazodone, benzatropine, cyproheptadine, den beta blockers, particularly propranolol.

Na dem first use de term by Czech neuropsychiatrist Ladislav Haškovec, wey describe de phenomenon insyd 1901 long before de discovery of antipsychotics, wey dem firstbdescribe drug-induced akathisia insyd 1960. E be from Greek a-, wey dey mean "not", den καθίζειν kathízein, wey dey mean "to sit", anaa insyd oda words an "inability to sit".