ABSTRACT
HISTORICAL BACKGROUND The term ‘‘akathisia’’ (from Greek, literally ‘‘not to sit’’) was introduced by Haskovec [1] in 1901, much before the introduction of neuroleptic drugs, to describe two patients with restlessness and an inability to sit still. Earlier descriptions of a similar syndrome can be traced back to the seventeenth century [2]. The first description of neuroleptic drug-induced akathisia is attributed to Sigwald et al. [3]. In the intervening period, restlessness had been described in association with Parkinson’s disease [4,5], and Ekbom [6] gave a detailed account of the restless legs syndrome (RLS). As neuroleptic drugs came into general use in the 1950s, the occurrence of akathisia began to be increasingly recognized. The early European authors considered akathisia to be an extrapyramidal reaction, although until the 1960s many authors continued to regard it as a psychogenic response to the medication or the fact of being medicated. It was not until the 1970s [7] that clinicians recognised that akathisia was common and could manifest itself in multiple ways. Detailed descriptions of the syndrome subsequently began to emerge [8,9]. While most reports of akathisia described it as an acute side effect of neuroleptics, it was also recognised that akathisia could develop as a delayed
side effect, analogous to tardive dyskinesia. Akathisia has been described in association with a range of non-neuroleptic drugs. The distinction between druginduced akathisia and RLS has been firmly established, and the term akathisia has come to refer almost exclusively to the former.
