Akathesia
| Akathisia | |
|---|---|
| Synonyms | Acathisia |
| Common symptom-expression of akathisia | |
| Specialty | Neurology, psychiatry |
| Classification |
· ·
|
|---|---|
| External resources |
Akathisia is a movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, as well as by actions such as rocking while standing or sitting, lifting the feet as if marching on the spot, and crossing and uncrossing the legs while sitting. People with akathisia are unable to sit or keep still, are prone to feelings of restlessness, and they may also fidget, rock from foot to foot, and pace.
Antipsychotics (also known as neuroleptics), particularly the first generation antipsychotics, are the leading cause of akathisia. When antipsychotic-induced, akathisia is an extrapyramidal side effect. Akathisia is also a symptom of psychosis, bipolar disorder, and agitated depression. Akathisia is a component of the repetitive movements in some cases of autism and intellectual disability. Other known causes include side effects of other medications, and nearly any physical dependence-inducing drug during drug withdrawal. It is also associated with Parkinson's disease and related syndromes.
The term was coined by the Czech neuropsychiatrist Ladislav Haškovec (1866–1944), who described the phenomenon in 1901. The term is from Greek καθίζειν kathízein – "to sit", a- indicating negation or absence, lit. "inability to sit".
"Akathisia may range in intensity from a sense of disquiet or anxiety, to excruciating discomfort, particularly in the knees. Patients typically pace or move their legs for hours because the pressure on the knees reduces the discomfort somewhat; once their knees and legs become fatigued and they are unable to continue pacing, they sit or lie down, although this does not relieve the akathisia." At high doses or with potent drugs such as haloperidol (Haldol) or chlorpromazine (Thorazine/Largactil), the feeling can last all day from awakening to sleep. Akathisia can cause movement in the hands, arms, and trunk muscles. However, some people experience akathisia with no external signs, and is described as follows: "The akathisia affects the sufferer inside, causing feelings of despair, agitation, intense panic and worry, an augur of disaster that feels completely real, and in some cases, the person actually has a physical sensation of pain in the solar plexus area of the body that they claim feels hot to the touch, a burning ache that is unbearable." Their stillness is often a co-occurring extrapyramidal side effect of neuroleptic medication called akinesia. "High-functioning patients have described the feeling as a sense of inner tension and torment or chemical torture. A term many sufferers use is the feeling like they want to "peel off their own skin." Akathisia is linked to suicidal ideation and should be treated. In a psychiatric setting, patients who suffer from neuroleptic-induced akathisia often react by refusing treatment. In addition, patients with Obsessive Compulsive Disorder (OCD) are extremely susceptible to drug-induced akathesia, and, in a study of OCD patients on SSRIs, they developed severe akathesia after a single dose of the antipsychotic Amisulpride.
...
Wikipedia