Akathisia Variants and Tardive Dyskinesia-Reply

In Reply.—  Akathisia, a stepchild of movement disorders and an orphan of psychiatry, is beginning to receive the serious attention and clarification it deserves. However, further debate will be necessary to generate a consensus among psychiatrists, neurologists, and pharmacologists as to the meaning and definition of the term akathisia. Barnes and Braude¹ have introduced some disciplined thinking and provocative proposals, which are long overdue, for the concept of akathisia. The major point of my editorial comment² on the Barnes and Braude article¹ was to emphasize the importance of investigating the natural history whereby acute neuroleptic side effects, such as akathisia, develop into the chronic side effect, tardive dyskinesia, and to do so paying attention to the natural history of the underlying schizophrenic illness.The letter by Dr Munetz addresses another important point: are akathisia and tardive dyskinesia voluntary or involuntary? Munetz suggests that akathisia movements are voluntary and that