Akathisia Treatment: What Works and What to Avoid

When you start a new medication—especially an antipsychotic—and suddenly feel like you can’t sit still, your body might be reacting to akathisia, a movement disorder marked by intense inner restlessness and an urgent need to move. Also known as drug-induced akathisia, it’s not just anxiety or nervous energy—it’s a physical compulsion that can make sleeping, sitting, or even standing unbearable. This isn’t rare. Studies show up to 25% of people on certain antipsychotics develop it, and many doctors miss the link because the symptoms look like worsening mental health.

Antipsychotic medications, drugs used to treat schizophrenia, bipolar disorder, and severe depression are the most common cause. But it can also come from SSRIs, anti-nausea pills like metoclopramide, or even some migraine meds. The key is recognizing it’s not in your head—it’s in your nervous system. You don’t need more therapy; you need a medication change or an add-on that calms the overactive motor signals. Beta-blockers, like propranolol, are often the first-line fix because they reduce the physical jitteriness without sedating you. Benzodiazepines like clonazepam can help too, but they carry dependency risks. Some patients find relief with vitamin B6 or mirtazapine, though those aren’t for everyone.

What doesn’t work? Doubling down on the drug that caused it. Some doctors think the restlessness means the illness is getting worse, so they increase the dose—making things ten times worse. That’s a trap. The real fix is identifying the trigger, lowering the dose if possible, or switching to a lower-risk antipsychotic like quetiapine or clozapine. And if you’re on a generic version of a drug you’ve had issues with before, don’t assume it’s safe—some generics have different fillers that can trigger side effects.

You’re not alone if you’ve been told it’s "just stress" or "all in your head." But akathisia is real, measurable, and treatable. The posts below cover exactly how to spot it early, what meds to ask your doctor about, and how to avoid the most common mistakes when managing it. You’ll find real stories, clinical insights, and clear steps to take control—before the restlessness takes over.