Duhaime's Law Dictionary


Akathisia Definition:

Psychomotor restlessness.

Related Terms: Attention Deficit Hyperactivity Disorder, ADHD or ADD

Also spelled akathesia and even acathisia.

Derived from Greek; means "not to sit" as in "not sitting still".

Similar to, but distinct from, Parkinson disease

Often seen as nervous fidgeting of the legs or arms, fingers, lips, eyes - any or all of the muscles - but akathisia is distinguished by the involuntary nature of the twitching.

Akathisia suffers from a lack of diagnostic criteria and sufferers are subject to a misdiagnosis of their symptoms as related to a mental disorder.

Sachdev wrote, in 1995:

"[T]he diagnosis (of akathisia) is primarily clinical and no laboratory indices are available."

This can lead to a prescription of neuroleptics (antipsychotic drugs) and aggravated symptoms. Antipsychotic drugs can exacerbate or induce, rather than alleviate the symptoms of akathisia.

Notice the reference in this regard in Fleming v Reid by Justice Robins:

"The use of neuroleptics anti-psychotic drugs) in the treatment of various psychoses is generally effective in improving the mental condition of the patient by alleviating the symptoms of mental disorder.

"It is clear, however, that they may not be helpful in every case. Moreover the efficacy of the drugs is complicated by a number of serious side effects which are associated with their use. These include a number of muscular side effects known as extra-pyramidal reactions: dystonia (muscle spasms, particularly in the face and arms, irregular flexing, writhing or grimacing and protrusion of the tongue); akathesia (internal restlessness or agitation, an inability to sit still); akinesia (physical immobility and lack of spontaneity); and Parkinsonisms (mask-like facial expression, drooling, muscle stiffness, tremors, shuffling gait).

"The drugs can also cause a number of non-muscular side effects, such as blurred vision, dry mouth and throat, weight gain, dizziness, fainting depression, low blood pressure and, less frequently, cardiovascular changes and, on occasion, sudden death."

REFERENCES:

  • Barnes, Thomas, A Rating Scale for Drug-Induced Akathisia, 154 British Journal of Psychiatry 672 (1989)
  • Fleming v Reid, 82 D.L.R. (4th) 298 (ONCA, 1991)
  • Sachdev, Perminder, Akathisia and Restless Legs (Cambridge: Cambridge University Press, 1995)

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