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What Causes Drug-Induced Akathisia

Last Updated on January 27, 2022 by Carol Gillette


Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

What Causes Drug-Induced Akathisia?

Many of us have heard the rapidly mentioned side effect lists at the end of drug commercials. No matter how many benefits a medication claims to provide, most still seem to have a long list of possible risks or side effects that go with them. In some cases, these risks seem worth it for the relief that the medication brings. However, in many cases, these side effects end up being worse than the condition itself, rendering the medication fairly useless. Unfortunately, this is the way of Western medicine.

Prescriptions and medications often come with horrific downsides, and as a culture, we have been taught to ignore them for the temporary or perceived relief that the medication brings to us. One such side effect is Akathisia1, which can rapidly progress from irritating to life-threatening if not addressed.

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What Does Akathisia Feel Like?

What Is Akathisia?

Most patients have different experiences with Akathisia2, so it can be difficult to nail down one definition. In general terms, Akathisia is involuntary restlessness, jitteriness, and need to move. Many times, this manifests as the uncontrollable urge to shift one’s weight from one leg to another, cross one’s legs and uncross them again, and the internal need to be in motion. This is an uncomfortable side effect of many medications, and it can occur in different ways for different people, depending on their disposition, their medication, and the dosage that they are taking. Akathisia itself generally occurs within the first six months of taking a medication. This condition is fairly common but is not found in people who have not or are not taking antipsychotic medication or other mental health-related medicines.

What Is Tardive Akathisia?

Tardive is simply a medical term to mean delayed. Tardive Akathisia, therefore, is Akathisia that has a delayed onset. Most people who experience Akathisia symptoms find that they happen within the first six months of taking a new medication. Tardive Akathisia occurs when no Akathisia symptoms occur immediately upon taking medication but rather show up months or years into the prescription. A good rule of thumb is that if the Akathisia appears six or more months after beginning the prescription, it can be classified as Tardive Akathisia3.

What Drugs Can Cause Akathisia?

Akathisia has been linked to the use of prescription antipsychotic drugs and other medications prescribed for mental health disorders or conditions. This condition does not occur for everyone who takes these medications, but it is a significant risk for many classifications of psychotic drugs. It seems that old or more primitive versions of antipsychotic medications pose the biggest risk for Akathisia4.

Some examples of these include:

  • Chlorpromazine
  • Loxapine
  • Trifluoperazine
  • Fluphenazine

These medications have all been updated since they were first developed, but in some cases, doctors prescribe these original recipes to patients to achieve the desired results. However, it is important to note that psychotic drugs of any kind pose a risk of Akathisia.

Even medication classifications that are deemed as “mild,” such as SSRIs, pose a risk of Akathisia.

Commonly used SSRIs include:

  • Lexapro
  • Celexa
  • Zoloft
  • Prozac
  • Paxil


There are many more brands and versions of SSRIs that are commonly prescribed, and all of them can put patients at risk for Akathisia. Unfortunately, this side effect is often not discussed with patients, nor is the risk of Akathisia itself.

What Does Akathisia Feel Like?

Akathisia is not a comfortable condition, and it affects everyone differently5. There are several different ways in which the condition has been described, but in general, it is a feeling of extreme restlessness. Some people report feeling “like they’re going to jump out of their skin,” while others simply feel fidgety or restless. Many people get the uncontrollable urge to move their legs or feet in some way, 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. For long-term sufferers, there has even been an increased risk of suicidal thoughts and behaviors.

Is Akathisia Reversible?

Not everyone who takes medications will experience Akathisia symptoms, but many will. For those who experience it immediately after beginning medication, the symptoms generally subside within six months or so. Tardive Akathisia occurs after this time and can last any length of time. In some cases, Akathisia is even chronic, meaning that it occurs for a long period of time (6 months or more) and shows no sign of stopping. For many people, the symptoms go away at some point after stopping a medication that causes the condition.

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 take our brain’s chemicals and ensure that they are properly distributed. This entire system is more involved, but it is important to note the receptors specifically. Our brain has four main hormones that keep us functioning properly: Serotonin, Glutamate, Dopamine, and Norepinephrine. Mental illness occurs when one or many of these hormones are not reaching the correct areas of the brain in the correct ways. Mental health medications are meant to help the hormones get to the correct places when the brain is not doing this process efficiently or correctly. Antipsychotic medications deal specifically with Dopamine and Dopamine receptors. In many cases, Antipsychotic drugs try to block receptors to make psychotic episodes less likely.

Dopamine’s Effect on the Brain

Most people associate Dopamine with happiness. While this is partially true, it does not paint the whole picture of the hormone’s purpose. While Dopamine does focus on our pleasure centers and reward systems, it also helps to target things like emotions and impulses. Most importantly, Dopamine is key in maintaining muscle control. If we don’t have enough Dopamine, our body can feel lethargic.


Low levels of Dopamine can lead to conditions such as Parkinson’s, which affects a person’s movement. On the other end, too much Dopamine can be harmful as well. High levels of Dopamine can have an effect that is similar to that of amphetamines. This classification of drugs includes prescriptions such as Ritalin and Adderall.

Dopamine and Akathisia

Many medical professionals do not totally understand why Akathisia occurs, and despite research on the topic, there is no solution for it as long as a patient is on a mental health medication6. The general theory is that changes in Dopamine receptors are what cause Akathisia to occur. For those taking Antipsychotics, Dopamine receptors are blocked to prevent the high/psychotic episodes that can come with too much dopamine. SSRIs do nearly the opposite in that they simply direct Dopamine to the correct receptors without blocking their absorption at all. It seems that both low levels and high levels of Dopamine cause a lack of control over one’s muscles, causing the symptoms of Akathisia.

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. Antipsychotic discontinuation is a great way to treat the uncomfortable and intrusive symptoms of Akathisia.

However, there needs to be a significant amount of trust in natural and holistic healing to be able to be fully treated for both Akathisia and the condition for which the antipsychotic medication was prescribed in the first place.

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

Neurochemistry 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.

Healthy Diet

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 symptoms7. 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. “What is akathisia?” Medical News Today

2. Pringsheim T MD et al “The Assessment and Treatment of Antipsychotic-Induced Akathisia” NCBI, published online 2018 Apr 23

3. Salem H et al “Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges” NCBI, published online 2017 Jul

4. Thomas JE et al “The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis” NCBI, published online 2015 Sep

5. Watson S “What Is Akathisia?” Healthline, medically reviewed by Timothy J. Legg, Ph.D., CRNP, updated 2018 Sep 29

6. Patel J, Marwaha R “Akathisia” NCBI, updated 2020 Nov 29

7. Medication Frequently Asked Questions National Alliance on Mental Illness

Originally Published May 6, 2021 by Diane Ridaeus

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

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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What Causes Drug-Induced Akathisia
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