A Name for the Unbearable
At the dawn of the 20th century, before modern psychiatric drugs existed, Czech neuropsychiatrist Ladislav Haškovec described a strange phenomenon: patients tormented by an inability to sit still. In 1901, he gave it a name drawn from Greek – akathisia, literally “not to sit.”
Before the Drug Era
Haškovec’s observations were not tied to medication. Akathisia was seen as a neuropsychiatric state, and later descriptions would link similar restlessness to Parkinson’s disease and other disorders. Only decades later would drugs become a central part of its story.
The Antipsychotic Revolution – and Its Price
In the 1950s, powerful new antipsychotic drugs like chlorpromazine transformed psychiatric care, allowing many people with severe mental illness to live outside institutions for the first time.
But in 1954, the first reports of medication-induced akathisia from chlorpromazine emerged. By 1960, akathisia was being reported with phenothiazines, another major antipsychotic class. A pattern was clear: these drugs could calm psychosis yet stir up unbearable restlessness.
Over time, akathisia was formally grouped with other extrapyramidal side effects – movement disorders caused by antipsychotics, including tremors, rigidity, and abnormal involuntary movements.
A Tool of Repression
In the former Soviet Union, the story took a darker turn. Reports emerged that akathisia-inducing drugs were allegedly used not for healing, but for punishment and control.
Haloperidol, a potent antipsychotic, was reportedly administered to prisoners to induce intense restlessness and Parkinson’s-type symptoms. The same chemical action that could quell hallucinations in a hospital became, in this context, a means of torment – keeping prisoners in relentless discomfort without leaving obvious marks of physical violence.
Akathisia in the Modern Spotlight
Even in recent years, akathisia has continued to appear in public discussion. In 2020, Canadian clinical psychologist and professor Jordan Peterson was diagnosed with akathisia after treatment with benzodiazepines for insomnia and depression, in the context of an autoimmune disorder, and later received treatment in Russia.
His case brought renewed attention to how easily the condition can arise from common medications, and how devastating its impact can be, even for those familiar with mental health.
The Takeaway
From Haškovec’s early description of “not being able to sit” to alleged use as a chemical instrument of torture, akathisia’s history reveals the double-edged power of psychiatric drugs. The same agents that can restore sanity and function can, in the wrong hands or the wrong doses, become tools of unspeakable inner torment.