ALTHOUGH NEUROLEPTIC DRUGS ARE EFFECTIVE IN THE CONTROL OF PSYCHOTIC BEHAVIOR, THEY DO HAVE THE SIDE EFFECT OF PRODUCING AKATHISIA, A SUBJECTIVE DESIRE IN THE PATIENT TO BE IN CONSTANT MOTION. THIS FEELING OF INNER AGITATION AND MUSCLE TENSION CAUSES THE PATIENT TO PACE CONSTANTLY AND MAY PRECIPITATE VIOLENCE. A SOCIOPATHIC YOUNG MAN BEING TREATED FOR DEPRESSION WAS GIVEN IMIPRAMINE HYDROCHLORIDE, AND THE INITIAL RESPONSE WAS A DECREASE IN HIS FEELINGS OF DEPRESSION. AFTER 6 WEEKS OF THERAPY, HOWEVER, HE BECAME HOSTILE AND COMPLAINED OF THOUGHT DISORGANIZATION. THE IMIPRAMINE DOSAGE WAS DECREASED AND SUPPLEMENTED WITH HALOPERIDOL IN INCREASING DOSES. THE PATIENT BECAME UNCONTROLLABLY AGITATED, COULD NOT SIT STILL, AND PACED FOR SEVERAL HOURS AFTER EACH DOSE. HIS ANXIETY CULMINATED IN AN ATTEMPT TO KILL HIS DOG AND WAS BARELY CONTROLLED WITH COUNTERDOSES OF THIORIDAZINE HYDROCHLORIDE. WITH MODIFICATIONS OF THE PATIENT'S DRUG TREATMENT NO SUBSEQUENT AKATHISIA AND CONCOMITANT VIOLENCE OCCURRED. CLINICIANS SHOULD BE AWARE OF THE POSSIBLE AKATHITIC REACTION TO THESE DRUGS. REFERENCES ARE PROVIDED. (TWK).