Akathisia variants and tardive dyskinesia

• Eighty-two schizophrenic outpatients receiving maintenance antipsychotic medication were assessed for akathisia and dyskinesia. Thirty-nine (48%) manifested patterns of nondyskinetic, restless movement characteristic of akathisia. On the basis of their clinical features, these patients were divided into three groups: akathisia (recent onset, related to an increase in antipsychotic drug dose); pseudoakathisia (motor signs but no subjective symptoms); and akathisia (a mixed category including persistent acute akathisia and tardive akathisia with the pharmacologic characteristics of dyskinesia). Coarse, jerky foot tremor was observed as an invariable accompaniment of acute akathisia. A significant association was found between choreoathetoid limb dyskinesias, orofacial dyskinesias, and the presence of chronic akathisia. Also, the findings suggested a possible relationship between pseudoakathisia, orofacial and limb dyskinesia, and the severity of negative schizophrenic symptoms.