Restlessness of Respiration as a Manifestation of Akathisia: Five Case Reports of Respiratory Akathisia
J Clin Psychiatry 2000;61(10):737-741
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Background: Akathisia is a feeling of subjective
or inner restlessness, which causes excessive, semipurposeful
movements, commonly in the legs. However, restlessness in
respiration, which presents as dyspnea but is best characterized
as the sensation of being unable to breathe in a relaxed manner,
has never been reported.
Case Reports: Five cases are reported in which
dyspnea as a sign of akathisia followed the administration of
antipsychotic medications. The clinical features of dyspnea were
examined, and all patients manifested both subjective and
objective restlessness. The dyspnea was characterized
subjectively by the patients' inner feeling of restlessness in
respiration, which was perceived as an inability to breathe in a
leisurely, relaxed manner, and objectively as restless movements
of respiration such as gasping or sighing. The dyspnea was
momentarily suppressed when a patient took a quick, full breath
to relieve the perceived restlessness and was exacerbated when
the patient kept the respiration still. Response to medications
commonly used in the treatment of akathisia was also examined in
an open, uncontrolled therapeutic trial for each patient. The
administration of such medications completely alleviated the
Conclusion: Restlessness in respiration, which
clinically presents as dyspnea, may be a manifestation of
akathisia. This type of akathisia could be referred to as respiratory