Overview
Akathisia refers to a severe restlessness that produces an uncontrollable urge to move around, such as pacing, rocking, fidgeting, or constant shifting.
Within substance use disorders, it can be both a risk factor and a complication of withdrawal. Medications that block dopamine receptors like antipsychotics or alter serotonin levels like SSRIs can trigger akathisia. It’s also possible for withdrawals from opioids, alcohol, benzodiazepines, and stimulants to provoke akathisia as one’s neurochemistry undergoes rapid changes. At the same time, someone who experiences akathisia might end up self-medicating with those very substances to alleviate the physical and mental discomfort, which can quickly become a rapid spiral of using substances to avoid the symptoms caused by using the substances. It’s unfortunately possible for akathisia to be mistaken for worsening psychiatric symptoms, which can lead doctors to increase the dose of medications that trigger it.