Akathisia from medications like antipsychotics is often mistaken for anxiety, leading to dangerous treatment errors. Learn how to recognize the difference from restless legs syndrome and what treatments actually work.
Akathisia Treatment: What Works and What to Avoid
When you’re stuck with an unbearable urge to move—rocking, pacing, shifting your weight constantly—it’s not just restlessness. It’s akathisia, a distressing movement disorder often caused by psychiatric medications, especially antipsychotics and SSRIs. Also known as medication-induced restlessness, it’s not in your head. Your body is screaming for motion, and no amount of willpower stops it. This isn’t anxiety. It’s not insomnia. It’s a physical reaction to drugs meant to help you, and it’s more common than most doctors admit.
Antipsychotics, like risperidone, haloperidol, and olanzapine are the usual suspects. But SSRIs, including fluoxetine and sertraline—commonly prescribed for depression and anxiety—can trigger it too. Even some anti-nausea drugs like metoclopramide can cause akathisia. The problem? Many patients are told they’re just "nervous" or "stressed," when the real fix is stopping or switching the drug causing it. And here’s the catch: if you’re on multiple meds, the risk jumps. Polypharmacy doesn’t just complicate things—it multiplies danger.
So what actually helps? Benzodiazepines, like clonazepam or lorazepam are often the first-line treatment because they calm the nervous system fast. Beta-blockers like propranolol also work well for many—reducing the physical jitter and urge to move. In some cases, lowering the dose of the offending drug or switching to one with lower akathisia risk (like quetiapine or clozapine) makes all the difference. But don’t just quit cold turkey. Abrupt changes can make symptoms worse or trigger withdrawal. Talk to your doctor about a slow taper.
What doesn’t work? Adding more antipsychotics to "treat" the restlessness. That’s like pouring gasoline on a fire. Some doctors still do it, thinking it’s a psychiatric symptom. It’s not. It’s a neurological side effect. And if you’re dealing with this while on a generic version of a drug you used to tolerate on brand, don’t assume it’s "all in your head." The placebo effect cuts both ways—sometimes, you feel worse because you think generics are inferior. But akathisia doesn’t care about your beliefs. It cares about your chemistry.
People over 65, those with Parkinson’s, and anyone with a history of movement disorders are at higher risk. But it can hit anyone—especially if they’ve recently started or changed a psychiatric med. If you’ve noticed this restlessness within days or weeks of a new prescription, it’s likely the cause. Keep a log: when it started, what meds you took, how bad it got. Bring that to your doctor. Most cases improve within days of adjusting the trigger. A few need longer-term management.
The posts below cover real cases and practical fixes—from how SSRIs quietly cause akathisia, to why switching to generics can backfire in older adults, to what to do when your doctor dismisses your symptoms. You’ll find advice on safe med swaps, how to spot early signs, and which supplements to avoid (yes, some make it worse). No fluff. No jargon. Just what works when you’re stuck in motion and no one seems to get it.