Akathisia is a movement disorder characterized by a subjective experience of restlessness alongside an urge to move, generating repetitive movements. Its clinical presentation can be confusing and vague, making the diagnosis often problematic and posing an important challenge in clinical practice. This challenge stems not only from its symptoms and difficult treatment, but also from the association with aggression and violence, emergence and/or worsening of suicidal ideation, insomnia and exacerbation of the psychotic illness.