Acatisia: the imperative need for movement

Acatisia: the imperative need for movement

Achatisia refers to a neurological motor disorder that implies the inability of the person to remain still, accompanied by a subjective and internal feeling of restlessness, as well as a compulsion to move.


  • 1 Acatisia and restless legs syndrome (SPI)
  • 2 Acatisia: symptomatology
  • 3 Acute neuroleptic-induced acatisia
  • 4 Pregnancy and acatisia
  • 5 Twelve tips for patients with acatisia

Acatisia and restless legs syndrome (SPI)

The patient with acatisia experiences an inevitable need to keep moving continuously, the condition involves motor manifestations that can be observable, such as restless legs syndrome (SPI) or Willis-Ekbom disease (EWE), which is a disease characterized by the imperative need to move the legs.

It can be seen in certain patients with Parkinson's disease and as a side effect of the withdrawal or overdose of calcium channel blockers, lithium, buspirones, metoclopramides, selective serotinin reuptake inhibitors (SSRIs), dopaminergic agentsneuroleptics, antiemetic drugs, withdrawal from some drugs such as: barbiturates, cocaine, opiates and amphetamines, among others. People suffering from acatisia usually have an iron deficit.

It is important to identify this disorder early for its timely intervention, since it is often confused with anxious motor manifestations, which often leads to increased doses of antipsychotics and contributes to the progression of the disease. What are some of the most serious consequences that akathisia can cause? It can cause suicidal ideation, different nerve disorders and paralysis, the latter may be irreversible.

The neurological ethilology of Restless Leg Syndrome (SPI), includes alterations of the peripheral nervous system, such as: neuropathies-polyneuropathies (by amyloidosis, cryoglobulinemic, diabetic, alcoholic), infectious, traumatic myelopathies, deficiency, spinal anesthesia, radiculopathies or motor neuron disease (ENM), the latter affects different groups of nerves, it is called a group rare diseases, which affect neurons and spinal cord, causing weakness and muscle atrophy, as is the case with amyotrophic sclerosis (ALS), progressive bulbar paralysis (PBP) and progressive muscular atrophy (AMP); tremor and spinocerebellar ataxia. The Scottish Motor Neuron Disease Association provides information to patients with motor neuron disease (NMS).

Acatisia: symptomatology

Patients with acatisia experience a great need to move their legs especially at night, it forces them to wake up and not rest well the unpleasant sensations they experience as stinging, tingling, burning, cramping or pain, discomfort to the arms and at trunk: periodic limb movement disorder (MPE) The symptoms of akathisia are usually exacerbated during the afternoon and evening and may include:

Acute neuroleptic-induced acatisia

It occurs by reducing the dose of medication to treat extrapyramidal symptoms, within a few weeks of starting medication with neuroleptics or when their dose is increased. Timely intervention is necessary, in some extreme cases it can lead to suicide due to the terrible physical discomfort and emotional that the individual experiences.

The patient who presents an acute picture of akathisia, reports an inability to rest, accompanied by a series of motor manifestations such as alternating the support of one foot to the other, crossing and uncrossing the legs, striding, inability to sit or stand without moving, performing typical nervous movements. The symptoms of the condition can be amplified when there is comorbidity with other psychopathologies, a constant emotional tension and stress excessive.

When the person suffering from acatisia is at rest or inactive, a feeling of great discomfort occurs in him. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) of the American Psychiatric Association (APA), neuroleptic-induced acute acatisia appears within the category of medication-induced movement disorders and other adverse drug effects.

Pregnancy and Acatisia

What happens to acatisia during pregnancy? Sometimes the symptoms of acatisia disappear or lessen during pregnancy, although not always after the birth of the newborn, this is after childbirth or caesarean section. Its appearance is typical during the third trimester of pregnancy, has been correlated with low levels of iron-ferritin, vitamin B12 and folic acid, so important for the mother and the optimal development of the baby.

Twelve tips for patients with acatisia

  1. The ideal intervention includes several health professionals, including: neurologist, psychiatrist, psychologist and physiotherapist, mainly.
  2. Family and friends can represent a great support for the patient with acatisia, the fact that he feels understood, included and contained, is beneficial for him.
  3. Decrease anxiety and excess stress.
  4. Seek good sleep hygiene.
  5. Learn relaxation and meditation techniques.
  6. Biofeedback
  7. Participate in occupational and recreational activities that you find pleasant.
  8. It is advised that patients include vitamin B6 in their diet, they can be found in nuts, legumes, red meat, fish, cereals and yeast.
  9. Perform moderate physical activity and suggested by the attending physician.
  10. Acupuncture.
  11. Massages approved by the attending physician.
  12. Avoid caffeine, alcohol and energy drinks or stimulants, as well as reduce or eliminate tobacco consumption.

Once a body is in motion, it moves eternally, unless something prevents it; Whatever the thing that prevents this movement, it will not be able to extinguish it in an instant, but after a certain time, and gradually" Leviathan. Thomas Hobbes


Akathisia is a neuromotor condition that can have serious biopsychosocial consequences in which it suffers if it is not treated, the most serious can involve paralysis and suicide in extreme cases, so it is necessary to be diagnosed in a timely manner, for a adequate and multidisciplinary intervention.


Bibliographic references

  • Nemiah, John, C. (1996). Glossary of Psychiatry. 7th. Ed. Of the American Psychiatric Press, Inc. Madrid, Spain: Díaz De Santos, S.A.