Psychiatric Emergencies for Clinicians: Emergency Department Management of Acute Drug-Induced Akathisia

A 63-year-old man presents with a recent diagnosis of depression and a sleep disorder, complaining of “anxiety.” His medication had recently been changed to sertraline (Zoloft; Pfizer, New York, NY) 50 mg by his primary care provider (PCP). After taking his first morning dosage, he reported feeling progressive anxiety and restlessness. He described the anxiety as severe, constant, and not relieved or worsened by anything. His review of systems was negative for visual and auditory hallucinations, and he denied any suicidal or homicidal ideations.