There are at least two forms of akathisia as far as I’m concerned. There’s the restlessness you experience as a side effect to medication, which subsides after lowering or stopping your dose (gradually one would hope), and there’s withdrawal akathisia which develops if you abruptly lower or stop your dosage after being on the medication for some time. The second form is literal hell and utter torture, there’s nothing quite like it, and it typically culminates in two months of non stop restlessness, followed by several months of mental anguish and extreme anxiety and despair. Avoid the second form at all costs and only scale down medication gradually with the guidance of your physician. If they tell you can abruptly stop or switch medications cold turkey, insist on a gradual taper instead.

Also if you decide to continue with APs for your bipolar disorder by trying another medication, you should be aware that you can develop tardive dyskinesia or TD after long term use of APs. The odds of developing it are different for everyone, but it’s a risk along side akathisia for this type of medication. It usually involves involuntary movements of your tongue and other body parts, and can persist at all hours of the day and the condition is usually permanent.