What is the Difference Between Tardive Dyskinesia and Akathisia?

🆚 Go to Comparative Table 🆚

Tardive dyskinesia and akathisia are both movement disorders associated with the use of certain medications, particularly antipsychotic (neuroleptic) drugs. However, they have distinct differences:

  1. Nature of the disorder: Tardive dyskinesia is characterized by involuntary repetitive movements, often involving the face, mouth, fingers, or arms. Akathisia, on the other hand, is an internal sense of restlessness that may result in movement, such as rocking back and forth or excessive pacing.
  2. Awareness of movements: People with tardive dyskinesia are usually unaware of their movements, while those with akathisia know they are moving and find the movements distressing.
  3. Involvement of voluntary or involuntary movements: Akathisia is characterized by the voluntary or involuntary nature of the movements, while tardive dyskinesia involves involuntary movements.
  4. Onset and duration: Akathisia can be classified based on its time of onset and duration, with acute akathisia developing soon after taking the drug and lasting for less than six months, tardive akathisia developing months or years after taking the medicine, and chronic akathisia lasting for more than six months. Tardive dyskinesia, as the name suggests, typically develops after a long duration of taking the medication.
  5. Location of signs and symptoms: Akathisia mainly affects the lower limbs, while tardive dyskinesia often involves the face, arms, and trunk.
  6. Presence of other extrapyramidal symptoms: Extrapyramidal symptoms, such as Parkinsonism and dystonia, may accompany tardive dyskinesia but are not typically associated with akathisia.
  7. Response to pharmacologic interventions: Tardive dyskinesia and akathisia may respond differently to pharmacologic interventions.

It is important for healthcare providers to differentiate between these two disorders as they may have different treatments and implications for the patient's well-being.

Comparative Table: Tardive Dyskinesia vs Akathisia

Tardive dyskinesia and akathisia are both movement disorders that can be side effects of neuroleptic drugs, and although they should be easily distinguishable, they are often confused. Here is a table comparing the differences between the two conditions:

Feature Tardive Dyskinesia Akathisia
Nature of the disorder Involuntary movement disorder characterized by repetitive, purposeless movements Subjective disorder characterized by a desire to be in constant motion
Movements Brief, twisting movements of the face, mouth, fingers, or extremities Subjective feelings of inner restlessness or tension and an urge to move, often manifested as an inability to remain seated
Voluntary or Involuntary Involuntary Voluntary
Onset Tardive dyskinesia typically occurs after a long period of neuroleptic treatment, with 50% of cases occurring within the first month and 90% occurring within the first 3 months Akathisia usually occurs in an acute/subacute form, with 90% of cases occurring within 90 days of initiating DRBA treatment
Location Orofacial dyskinesias, involving repetitive oral, facial, and tongue movements Can only be assessed in the context of subjective complaints
Extrapyramidal Symptoms Tardive dyskinesia is an extrapyramidal symptom Akathisia is not an extrapyramidal symptom

It is important for clinicians to differentiate between tardive dyskinesia and akathisia in order to provide appropriate treatment and management for patients experiencing these movement disorders.