You are reviewing a patient recently started on an antipsychotic and want to assess for akathisia. Before revealing the answer, decide what you would look for and ask about.

Observe the patient directly during the consultation for visible restlessness — an inability to sit still, pacing, or shifting weight from foot to foot — but do not rely on observation alone, since the subjective component can be present and distressing even when outward movement is relatively subtle. Ask explicitly whether they feel an inner restlessness, tension, or unease, and whether they feel a compulsion to move that is difficult to resist. Establish the timing carefully in relation to starting or increasing the antipsychotic dose, since a clear temporal association is an important part of recognising this as a medication effect rather than simply a worsening of the underlying psychiatric condition or a separate anxiety state.