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Drug-Induced Akathisia

Last Updated on April 19, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

What is Drug-Induced Akathisia?

Drug-induced akathisia is one of the many possible side effects that some prescription drugs, notably antipsychotics, may cause. In many cases, drug side effects end up being worse than the original symptoms one sought relief for. Unfortunately, this is the way of Western medicine.

Akathisia is described as a state of restlessness which can rapidly progress from irritating to life-threatening if not addressed. Other prescription drugs associated with akathisia are listed below. Cocaine use is also associated with akathisia.1

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What Is Akathisia?

Akathisia is involuntary restlessness, jitteriness, an inability to remain still. Akathisia is a drug-induced condition. A person may experience an ongoing urge to shift one’s weight from one leg to another, cross and uncross one’s legs, march in place, rock back and forth, or other repetitive motions. There is an unrelenting need to be in constant motion.2-5

What Is Tardive Akathisia?

Akathisia can emerge within days of starting antipsychotic or increasing the dose. This is referred to as “acute akathisia”. Chronic akathisia onsets within a few weeks of taking medication. Tardive akathisia (delayed onset) can develop months or years into the prescription, and can persist even if the drug is discontinued. Withdrawal akathisia develops when a reduction of dose is introduced, or when a drug is discontinued, usually within a few weeks.3

What Drugs Can Cause Akathisia?

Akathisia has been most commonly linked to the use of antipsychotic drugs. Other drugs can also lead to akathisia. This condition does not occur for everyone who takes these medications. Studies suggest that antipsychotic medications pose the biggest risk for causing akathisia, but many other types of drugs can also cause the condition to occur.4

Some examples of antipsychotic medications that can induce akathisia include:
  • Aripiprazole
  • Asenapine
  • Lurasidone
Additional medications that can cause akathisia include:
  • SSRIs (selective serotonin reuptake inhibitors)
  • MAOIs (monoamine oxidase inhibitors)
  • TCAs (tricyclic antidepressants)
  • Antibiotics
  • Sodium channel blockers
  • Stimulants such as methamphetamines and cocaine
  • Antiemetics (anti-nausea drugs)

About 20% of patients taking bipolar treatment drugs experience akathisia. Unfortunately, the risk of akathisia is often not discussed with patients before prescribing a medication.3

What Does Akathisia Feel Like?

Akathisia is involuntary and uncomfortable, and in severe cases can be so debilitating as to lead to suicidal thoughts or actions. Some describe it as a feeling of extreme restlessness, or feeling like they’re going to jump out of their skin. A person may get the uncontrollable urge to constantly move their legs or feet and some even make involuntary vocal sounds such as moans or grunts. There is a feeling of helplessness and lack of control when suffering from akathisia. Many people are deeply embarrassed by their involuntary movements, and others may react by becoming aggressive or violent.5

Is Drug-induced Akathisia Reversible?

According to clinical research, if akathisia develops within a few weeks of taking an antipsychotic medication, the condition will typically reverse if the dosage is reduced, or if the person is switched to some other medication.5

The symptoms of akathisia may mimic those seen in psychosis and mania, and can be confusing to properly diagnose.

Antipsychotic Medications and How They Work

It is easier to understand why akathisia occurs when we look at what antipsychotic medications are meant to do. The human brain has many hormone receptors that distribute these natural chemicals throughout the body. Many types of hormones keep the body functioning properly: including serotonin, glutamate, dopamine, and norepinephrine. Mental health medications are presumed to manipulate, hold back, or increase the distribution of hormones and neurotransmitters. Antipsychotic medications deal primarily with the suppression of dopamine and dopamine receptors.

Dopamine’s Effect on the Brain

Most people associate dopamine with happiness. Dopamine activates the pleasure and reward centers and also targets emotions and impulses. Dopamine is key in maintaining muscle control. If we don’t have enough dopamine, the body can feel lethargic.

Low levels of dopamine can lead to conditions such as Parkinson’s, which can retard muscle movement.

Dopamine and Akathisia

The mechanism of akathisia onset is not understood. For those taking antipsychotics, it is thought that blocking dopamine receptors can suppress the psychotic episodes associated with schizophrenia.

Treating Akathisia

Unfortunately, if you follow Western medical practices, the solution to Akathisia is either to reduce your medication dose, increase your medication dose, or switch your medication altogether. Otherwise, there are not significant ways to mitigate the effects of this condition using prescriptions. However, there are many natural ways to help treat this disorder. One example is the use of Vitamin B6 to alleviate akathisia — however, more research is called for to discover the mechanisms involved.2

Addressing the Root of the Problem

Many forms of Western medicine do not take the time to diagnose and treat the root cause of a condition but rather provide a pill or medication that can mask or treat the symptoms. It’s true that many mental health medications provide a quick fix, which can be incredibly helpful in a crisis situation. However, when symptoms are masked, patients are not inspired to find the true cause of their issue. In many cases, there are imbalances at a molecular level that are leading to mental health issues and symptoms.

By using medication to cover up the symptoms, the root imbalance is never addressed, and no problem is ever solved. Many people with schizophrenia, for example, have increased levels of toxins in their bodies and blood. Getting rid of toxins could greatly reduce symptoms without the side effects of medication.

Neurochemistry as a Medicine

Healthy DietNeurochemistry is the root cause of almost every mental health condition. For a number of reasons, humans often find themselves with neurological imbalances that cause depression, anxiety, bipolar disorder, and other types of mental illnesses. Though this sounds scary, there are ways to bring the body’s neurochemistry back into balance and help a patient to live a normal and happy life.

However, this rebalancing cannot begin with medications in the system. Medications throw off the body’s natural chemistry and make it difficult to address the root problem. Rebalancing neurochemistry can be achieved in several ways. Implementing and maintaining a healthy diet, cutting out drugs and alcohol of all kinds, and beginning exercise regimens are wonderful first steps. During this time of rebalancing, counseling, yoga, art therapy, massage, and other traditional Eastern tactics can help to calm the mind and body and promote healing from within. As the body rids itself of toxins and destabilizing chemicals and hormones, a sense of balance and calm is restored, and patients often see a reduction in mental illness symptoms without the use of drugs or medication.

Medication Withdrawal Programs

Here at ATMC, we begin our treatments with a medication withdrawal protocol. Because no two clients are the same, we create an individualized approach for every person who walks through the door. For some situations, simple medication tapering will be all that is necessary. For other cases, the tapering must be accompanied by an intermediary medicine to have the best effect. Our goal is to get our patients off of their medications in the gentlest way possible. Withdrawal can be excruciating, and many people want to run back to their medication while they experience the symptoms.

However, with our programs, you can safely and comfortably wean yourself off of medications and begin the natural healing process.

Diagnoses Are Not Definitive

Many people believe that a mental health diagnosis is the end of the line and that they will suffer forever. While Western medicine has definitely encouraged this opinion, it is not necessarily the truth. For many people, holistic treatment provides a long-term and sustainable solution to their symptoms.7 After many years of feeling better, most of these patients would not be diagnosable with the conditions that they once thought would rule their lives. The reason that many people believe that their diagnosis defines their future is that medications ensure that you will remain chained to your illness.

The medicines mask the symptoms but do not cure them, meaning that you will likely suffer in the long term. Holistic and natural approaches target the root cause. Though it may take a little bit longer, in the end, your results are more permanent, and you can see a lasting change in your life. In this way, your diagnosis can become inaccurate or obsolete.

Contact ATMC

For almost two decades, the Alternative to Meds Center has been providing effective holistic treatment for mental conditions of all kinds. Our methods are comprehensive and sustainable and ensure that you reach true healing from within. Everyone is on a different journey, and there is never any judgment when you walk through our door. Our only aim is to ensure that you feel the best that you possibly can, all the way down to the molecular level.

If you are ready to make the switch from medication to healing, contact us today.


1. Patel J, Marwaha R. Akathisia. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: [cited 2024 April 18]

2. Pringsheim T, Gardner D, Addington D, Martino D, Morgante F, Ricciardi L, Poole N, Remington G, Edwards M, Carson A, Barnes TRE. The Assessment and Treatment of Antipsychotic-Induced Akathisia. Can J Psychiatry. 2018 Nov;63(11):719-729. doi: 10.1177/0706743718760288. Epub 2018 Apr 23. PMID: 29685069; PMCID: PMC6299189.[cited 2024 April 18]

3. Salem H, Nagpal C, Pigott T, Teixeira AL. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges. Curr Neuropharmacol. 2017;15(5):789-798. doi: 10.2174/1570159X14666161208153644. PMID: 27928948; PMCID: PMC5771055. [cited 2024 April 18]

4. Thomas JE, Caballero J, Harrington CA. The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis. Curr Neuropharmacol. 2015;13(5):681-91. doi: 10.2174/1570159×13666150115220221. PMID: 26467415; PMCID: PMC4761637. [cited 2024 April 18]

5. Thippaiah SM, Fargason RE, Birur B. Struggling to find Effective Pharmacologic Options for Akathisia? B-CALM! Psychopharmacol Bull. 2021 Jun 1;51(3):72-78. PMID: 34421146; PMCID: PMC8374932. [cited 2024 April 18]



Originally Published May 6, 2021 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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