akateesiat

Akateesiat, commonly referred to in English as akathisia, is a movement disorder defined by an inner sense of restlessness and an urgent need to move. People with akateesiat often pace, shift their weight from foot to foot, fidget, tap their feet, or repeatedly adjust their position. The distress from this restlessness can interfere with sleep, functioning, and quality of life. The condition is frequently a side effect of medications that affect dopamine pathways in the brain, but it can also arise from other drugs or medical conditions.

Causes and onset. Akateesiat is most often linked to dopamine D2 receptor antagonists used in psychiatry, including high-potency typical antipsychotics and some atypical antipsychotics. It can also occur with antidepressants, antiemetics, stimulants, and withdrawal from certain drugs. Symptoms typically begin within days to weeks after starting or increasing the dose of a triggering medication, though onset can vary. Other medical or psychiatric conditions may mimic restlessness, so careful assessment is important.

Diagnosis and assessment. Diagnosis is clinical and based on history and observation. Clinicians may use standardized scales such as the Barnes Akathisia Rating Scale to document the severity and impact on function. It is important to distinguish akateesiat from anxiety, agitation due to delirium, or other movement disorders.

Treatment and management. The primary approach is to modify the offending medication—lower the dose, switch to a drug with a lower risk of akathisia, or discontinue use if possible. Symptom-directed treatments include propranolol or benzodiazepines; anticholinergic agents may be used in some cases, though evidence varies. In persistent or refractory cases, newer medications that reduce dopamine-related side effects, including VMAT2 inhibitors, may be considered. Supportive care and reassurance are also important to reduce distress.

Prognosis and epidemiology. Incidence varies with drug type and dosage; akateesiat is more common with certain antipsychotics and may improve after dose adjustment or drug change. Early recognition and treatment generally lead to better outcomes, though some cases can persist if the triggering medication cannot be modified.