Akathisia Treatment: What Works and What to Avoid

When you can’t sit still—your legs twitch, your body fidgets, and even standing feels unbearable—you’re not just anxious. You might have akathisia, a movement disorder caused by certain medications that makes you feel an unbearable urge to move. Also known as medication-induced restlessness, it’s not a mental health symptom—it’s a physical reaction to drugs that block dopamine in the brain. This isn’t something you can just ‘calm down’ from. It’s a real, measurable condition that shows up after starting or increasing doses of antipsychotics, antidepressants, or even some anti-nausea meds.

Akathisia often gets mistaken for worsening anxiety or ADHD, but it’s different. People describe it as feeling like ants are crawling under their skin, or like their bones are vibrating. Some pace for hours. Others shift weight constantly, rock back and forth, or cross and uncross their legs nonstop. It’s exhausting. And if left untreated, it can make people stop taking life-saving medications—because the side effect feels worse than the illness.

The good news? dopamine blockers, the class of drugs that trigger akathisia, include common antipsychotics like risperidone and haloperidol aren’t the only players here. Treatment options exist, and they don’t always mean adding more drugs. Reducing the dose of the offending medication often helps. Switching to a different antipsychotic—like clozapine or quetiapine—can cut symptoms fast. Beta-blockers like propranolol are frequently used because they calm the nervous system without touching dopamine. Some people find relief with benzodiazepines like clonazepam, though these come with their own risks. Even vitamin B6 has shown promise in small studies for reducing symptoms without adding new side effects.

What doesn’t work? Pushing through it. Doubling down on the drug causing the problem. Or assuming it’s just "psychological." Akathisia is a neurological response, not a choice. And it’s more common than you think—up to 25% of people on certain antipsychotics develop it. Yet many doctors don’t screen for it. If you’re restless after starting a new med, speak up. Track when it started, how bad it gets, and what makes it better or worse. That data saves lives.

Below you’ll find real-world guides from people who’ve been there—how to recognize akathisia early, what meds to ask your doctor about, and which treatments actually help without creating new problems. No fluff. No theory. Just what works when you’re stuck in motion and can’t stop.