Research diagnostic criteria for drug-induced akathisia: conceptualization, rationale and proposal

This paper argues for consistency in the conceptualization and definition of drug-induced akathisia (DIA), something found lacking in published research reports. It suggests the adoption of a common set of provisional categories with operationally defined diagnostic criteria. The categories proposed are acute, tardive, withdrawal and chronic DIA, with overlap of chronic DIA with the other three. The prerequisites for diagnosis are drug exposure, the presence of characteristic clinical features and the exclusion of non-drug causes. The frequency of the clinical features, and their nature, determine the level of certainty. A decision regarding severity is made independently of diagnostic certainty. Some ways of testing the usefulness and validity of these definitions are discussed.