Akathisia is a medical condition characterized by inner restlessness, often caused by certain medications used to treat psychiatric conditions or disorders such as Parkinson’s disease. Recent studies link it to some antidepressants of the SSRI class, which can increase suicidal tendencies. Treatment involves stopping or lowering the levels of the drug causing the problem and using medications such as tranquilizers or antihistamines.
Akathisa, also spelled akathisia, is a medical term used to describe “inner restlessness,” often in response to taking certain types of medications designed to treat psychiatric conditions. It can also occur in people with certain disorders such as Parkinson’s disease or be the result of certain conditions such as the manic or hypomanic phase of bipolar I and II. Akathisia is often linked to the use of antipsychotics, but recent studies also link it to the use of some antidepressants of the SSRI class (selective serotonin reuptake inhibitors). Some doctors suggest that akathisia resulting from the use of SSRIs could create an increased suicidal tendency among patients who suffer from it.
Inner restlessness can be interpreted in many ways. Some people feel mild to moderately anxious or tense. Akathisia often expresses itself as a feeling of not being able to sit still, and severe cases may mean that a person needs to move, or becomes extremely whiny, has panic attacks, cannot sleep, and may not even be able to lie down to go to sleep. If you can think of a time when you were extremely anxious, worried, or restless about things, imagine feeling that for an extended period of time. If you’ve ever walked down a hospital floor expecting bad or good news about a loved one who is sick or in pain, or been so nervous about something that you couldn’t sleep, you’d have a good sense of what akathisia feels like. The main difference between people with this condition and those who experience occasional bouts of extreme worry or restlessness is that this condition is relentless and unrelenting.
SSRI studies suggest that some people develop the condition when given SSRIs. In this state, people are more likely to kill themselves or try to kill themselves than when they are in a depressive state. They feel that they have to do something to stop the restlessness, because there is not a single second of rest from it.
Unfortunately, some medications, particularly medications used to treat conditions such as schizophrenia, dissociative disorder, or delusions associated with manic depression, can make akathisia worse. A number of medications called neuroleptic antipsychotics list this as a common side effect. These include drugs such as haloperidol, clozapine, trazadone, perphenazine and chlorpromazine, to name a few. If you’re prescribed a neuroleptic antipsychotic drug or have started taking an SSRI, ask your doctor what symptoms you should look for, so you can get help quickly if you start experiencing 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 can be misdiagnosed as a major manifestation of psychotic symptoms. Instead of stopping a drug that is causing the problem, multiple drugs of the same drug 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 causing the problem. Other treatments that may help are medications with things like certain tranquilizers or even antihistamines. With greater knowledge of this difficult condition, which in its worst manifestations is tortuous to bear, it is hoped that patients who encounter it will get appropriate and immediate treatment. If you experience these symptoms, contact your doctor or psychiatrist right away and ask if akathisia is causing these feelings.
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