The development of the concept of akathisia: a historical overview

This paper traces the history of 'akathisia' and related syndromes, and examines the important studies that have helped shape our current understanding of the concept. Even though the term has come to be used synonymously with drug-induced akathisia, its origin was in the pre-neuroleptic era, and it is still often used to describe syndromes not related to medication. The literature clearly distinguishes restless legs syndrome (RLS) from akathisia. The complexity of the akathisia syndrome has increasingly become manifest, and a number of sub-types have been described. Recent attempts have been made to operationalize its diagnostic criteria and understand its pathophysiology. Akathisia due to non-neuroleptic drugs, in particular the serotonin-specific reuptake inhibitors (SSRIs), has also received much attention. The development of newer psychopharmacotherapeutic drugs, with different side-effects profiles, has made this focus pertinent and timely.