Restlessness of respiration as a manifestation of akathisia: five case reports of respiratory akathisia.
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.


METHODS
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 respiratory restlessness.


CONCLUSIONS
Restlessness in respiration, which clinically presents as dyspnea, may be a manifestation of akathisia. This type of akathisia could be referred to as respiratory akathisia.
Hirose
S
S
Fukui Prefectural Hospital, Japan. shigehiro@p2422.nsk.ne.jp
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy; D004417:Dyspnea / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000523:psychology; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy; D009626:Terminology as Topic
D014150:Antipsychotic Agents