Fact 13: Akathisia’s Intricate Relationship with Parkinson’s Disease
Akathisia and Parkinson’s disease both involve the central nervous system, but they are expressed in contrasting ways. While Parkinson’s disease is characterized by a decrease in dopamine leading to slowed, stiff movements, akathisia is typically seen as an outcome of disrupted dopamine activity causing restless and agitated movements. Interestingly, both conditions can exist in the same person, creating a clinical puzzle that can be challenging to solve.
People with Parkinson’s disease are more susceptible to developing akathisia for a couple of significant reasons. First, the dopamine depletion that underpins Parkinson’s disease sets the stage for a nervous system that is primed for the development of akathisia. Second, many of the medications used to manage Parkinson’s disease can actually induce akathisia as a side effect. These drugs, known as dopamine agonists, work by mimicking the effects of dopamine in the brain. However, they can also tip the balance too far, causing a surplus of dopamine activity and leading to the symptoms of akathisia.
Diagnosing akathisia in a person with Parkinson’s disease is no easy task. Both conditions involve the nervous system and movement control but in contrasting ways. While Parkinson’s disease is characterized by rigidity and bradykinesia (slowness of movement), akathisia presents with restlessness and a persistent urge to move. Clinicians need to sift through these symptoms, relying on a detailed medical history and careful clinical examination to make an accurate diagnosis.
When akathisia develops in a person with Parkinson’s disease, it can have a profound impact on their quality of life. The restless movements, inner restlessness, and discomfort associated with akathisia can add to the physical and psychological burden already experienced due to Parkinson’s disease. The restless, uncomfortable nights and the challenge of being in social situations can further isolate these individuals, exacerbating feelings of depression and anxiety that are already common in people with Parkinson’s disease.
Treating akathisia in Parkinson’s disease patients can be complex. Adjustments in Parkinson’s medications might be necessary, as well as considering the addition of drugs specifically targeted at managing akathisia symptoms. It’s a delicate balancing act, aiming to alleviate the distressing symptoms of akathisia without worsening Parkinson’s symptoms. It requires a personalized approach, taking into account the individual’s symptom severity, overall health status, and their personal response to medication adjustments. (13)
