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October 1986

Toward a More Reliable Diagnosis of Akathisia-Reply

Author Affiliations

Academic Unit Horton Hospital Epsom Surrey KT19 8PZ England

Arch Gen Psychiatry. 1986;43(10):1016. doi:10.1001/archpsyc.1986.01800100110020

In Reply.—  The letter by Drs Van Putten and Marder in response to our article suggests they are in broad agreement with most of our findings and conclusions. For example, they comment that observable restless movements may be absent in mild akathisia. This clinical observation is in line with our findings in a previous study of acute akathisia.1 The results of that study also suggested that anticholinergic drugs may only be effective in acute akathisia in cases where it accompanies severe parkinsonism. In such cases both conditions tended to improve. However, for the majority of patients with akathisia who received anticholinergics, and in whom there was no clear association between akathisia and parkinsonism, there was little or no benefit with these drugs. For chronic akathisia, the question of response to these agents remains open.Drs Van Putten and Marder also comment on the difficulty of distinguishing between normal purposeless