Akathisia is a frustratingly common side effect of antipsychotic medications and has a variety of presentations. It is generally conceived of as a feeling of internal restlessness or discomfort. Many patients may perform movements in order to relieve the internal tension they feel, such as this patient shifting in her chair throughout the interview. Akathisia is commonly thought of as an extrapyramidal sign associated with antipsychotics. The evidence base for the treatment of akathisia is growing, but generally the first line is to attempt to reduce or remove the offending medication. If that is not possible or desirable, then propranolol, benztropine, or benzodiazepines can be tried.