Hirose S
Fukui Prefectural Hospital, Japan.
J Clin Psychiatry. 2000 Oct;61(10):737-41. doi: 10.4088/jcp.v61n1005.
Akathisia is a feeling of subjective or inner restlessness, which causes excessive, semipurposeful movements, commonly in the legs. However, restlessness in respiration, which presents as dyspnea but is best characterized as the sensation of being unable to breathe in a relaxed manner, has never been reported.
Five cases are reported in which dyspnea as a sign of akathisia followed the administration of antipsychotic medications. The clinical features of dyspnea were examined, and all patients manifested both subjective and objective restlessness. The dyspnea was characterized subjectively by the patients' inner feeling of restlessness in respiration, which was perceived as an inability to breathe in a leisurely, relaxed manner, and objectively as restless movements of respiration such as gasping or sighing. The dyspnea was momentarily suppressed when a patient took a quick, full breath to relieve the perceived restlessness and was exacerbated when the patient kept the respiration still. Response to medications commonly used in the treatment of akathisia was also examined in an open, uncontrolled therapeutic trial for each patient. The administration of such medications completely alleviated the respiratory restlessness.
Restlessness in respiration, which clinically presents as dyspnea, may be a manifestation of akathisia. This type of akathisia could be referred to as respiratory akathisia.
静坐不能是一种主观的或内心的不安感，会导致过度的、半目的性的运动，常见于腿部。然而，呼吸方面的不安感，表现为呼吸困难，但最典型的特征是无法以放松的方式呼吸的感觉，此前从未有过报道。
报告了5例在使用抗精神病药物后出现以呼吸困难为表现的静坐不能的病例。对呼吸困难的临床特征进行了检查，所有患者均表现出主观和客观的不安。呼吸困难的主观特征是患者呼吸时内心的不安感，感觉无法悠闲、放松地呼吸，客观特征是呼吸的不安运动，如喘息或叹息。当患者快速深呼吸以缓解感觉到的不安时，呼吸困难会暂时缓解，而当患者保持呼吸静止时则会加重。在一项针对每位患者的开放、非对照治疗试验中，还检查了对常用治疗静坐不能药物的反应。使用此类药物可完全缓解呼吸不安。
临床上表现为呼吸困难的呼吸不安可能是静坐不能的一种表现。这种类型的静坐不能可称为呼吸性静坐不能。
