What is the recommended treatment for akathisia associated with Parkinsonism?

In the management of akathisia associated with Parkinsonism, starting an anticholinergic or a dopamine agonist is recommended. Akathisia is characterized by a feeling of inner restlessness and an uncontrollable urge to be in constant motion. It can arise due to dopaminergic treatments for Parkinson's disease or as part of the disease itself.

Anticholinergics, such as trihexyphenidyl, are effective in reducing parkinsonian symptoms and can alleviate the feelings of restlessness. Dopamine agonists, like pramipexole or ropinirole, may also help in managing akathisia as they can enhance dopaminergic activity in the brain, which might counteract the side effects of other dopaminergic medications that can lead to akathisia.

While benzodiazepines might provide symptomatic relief for anxiety or agitation, they are not the primary treatment for akathisia and may not address the underlying dopaminergic imbalance that contributes to the condition. Adjusting the dose of current medications or switching to non-dopaminergic options may not effectively resolve akathisia and could even exacerbate the underlying Parkinsonian symptoms. Therefore, utilizing an anticholinergic or a dopamine agonist is considered the