Medication-Induced Akathisia: Causes, Signs, and What to Do

When you take a medication for depression, psychosis, or nausea, you expect relief—not a feeling that your bones are crawling under your skin. Medication-induced akathisia, a movement disorder triggered by certain drugs that creates unbearable inner restlessness. Also known as drug-induced restlessness, it’s not just being fidgety. It’s the urge to move constantly, even when you’re exhausted, because sitting still feels like torture. This isn’t anxiety. It’s not ADHD. It’s a physical reaction to how the drug blocks dopamine in your brain, especially with antipsychotics, SSRIs, and even some anti-nausea pills like Reglan.

People often mistake akathisia for their condition getting worse. A patient on an antidepressant might tell their doctor, "I feel more anxious," when they’re actually suffering from akathisia. And if the doctor increases the dose thinking it’s not working, it gets worse. Antipsychotic side effects, like akathisia, are among the most underdiagnosed and dangerous reactions in psychiatry. Studies show up to 25% of people on first-generation antipsychotics develop it. Even newer drugs aren’t safe. The key is recognizing the timing: it usually starts within days to weeks after starting or increasing the dose. You might pace, rock back and forth, shift weight constantly, or feel like you can’t sit in a chair without jumping up.

Some people try to cope by drinking caffeine or smoking more, but that only makes the agitation worse. Others stop the drug cold—risky, because withdrawal can trigger even more problems. The real fix isn’t more pills. It’s adjusting the dose, switching to a different medication, or adding a proven counter-treatment like propranolol or benztropine. Akathisia treatment, often involves simple, low-risk interventions that many doctors don’t know to try. You don’t need a specialist to start fixing this—just the right questions to ask your provider.

What you’ll find below are real, practical posts from people who’ve lived through this. Some explain how they spotted akathisia in themselves after starting an SSRI. Others compare how different antipsychotics stack up in causing restlessness. One article breaks down why Reglan can trigger this even though it’s used for nausea. Another shows how iron levels and sleep habits can make the symptoms feel worse—or better. This isn’t theoretical. These are stories, data, and fixes from real patients and doctors who’ve seen this play out too many times.