Editorial Note: This post by Leonie Fennell is the first of two on related themes. We would love to hear any observations you or your veterinarian have on drugs in animals in general.
Depression, once a disease deemed too rare to merit study, has become so common that it is now a booming business. More and more people are asking: “When we stop at the pharmacy to pick up our Prozac, are we simply buying a drug? Or are we buying into a disease as well?” In the last 20 years depression numbers have rocketed and according to the World Health Organisation, more than 300 million people of all ages are suffering globally.
And it seems to be spreading to pets.
An article last week caught my attention – ‘Serotonin Syndrome in Dogs: Symptoms, Causes, & Treatment’. The article warns of the dangers of antidepressant-induced Serotonin Syndrome (SS), a condition that if left untreated, can result in ‘illness, altered mental states, and even death’. Considering I’ve seen first-hand the effects that antidepressants can have on humans, particularly depersonalization, aggression and suicidality, I have always wondered whether similar effects can be seen in canines. What might the growing practice of drugging our pets lead to?
An increased risk of antidepressant-induced ‘suicidality’ may be impossible to detect in animals, but it seems the deleterious effects of the drugs on us are similar in our canine companions. Symptoms of SS include confusion, depression, hyperactivity, lethargy, agitation, aggression and behavioral abnormalities. Bizarrely, it seems that vets are far more clued-in to the pharmacological effects on man’s best friend, than doctors are.
Given the unashamed push to medicate the masses, whether sick or healthy (as illustrated by the widespread use of statins), the progression to animals is hardly surprising. With the human market arguably close to saturation, dogs are increasingly being diagnosed with many psychiatric disorders, such as anxiety, depression and ‘separation anxiety’. While some of this is down to neurotic owners, the pharmaceutical industry also have clear motives in targeting the pet market – the market is an extremely lucrative one, with a recent report by the Federal Trade Commission estimating that U.S. retail sales of pet medications are expected to grow to $10.2 billion by 2018.
Reconcile
Undoubtedly, dog-owners do not set out to harm their beloved pets, yet when giving them psychotropic drugs, it is a distinct possibility. For instance, while benzodiazepines and tricyclic antidepressants are often prescribed to an ‘anxious’ canine, it seems far more likely that a vet will recommend an SSRI antidepressant (Selective Serotonin Reuptake Inhibitor).
Lilly’s SSRI fluoxetine (more widely known as Prozac) was approved for canine use by the FDA and repackaged for your doggie or moggy as ‘Reconcile’ for separation anxiety. Two other SSRIs, Paroxetine and Sertraline, although not approved for use in animals, are also prescribed by veterinarians for your dog’s woes. In the case of Reconcile, separation anxiety (dogs being left alone for lengthy periods) was the most common reason for prescribing in dogs, and in cats, inappropriate elimination (of urine).
Lilly’s own literature(1) report the following adverse reactions with dogs taking Reconcile/Prozac:
- Calm/Lethargy/Depression – 32.9%
- Shaking/Shivering/Tremor – 11.1%
- Restlessness – 7.4%
- Aggression – 4.2%
So, almost one in three dogs became depressed on Reconcile and an estimated 4 in 100 became aggressive. Furthermore, the reaction coded as ‘restlessness’ (at 7.4%) might sound innocuous but seems likely to be an indication of akathisia, a severe emotional state that often precipitates suicide in humans (see Dolin v GSK).
Considering little Fido cannot verbalise a drug-induced effect, it seems bizarre that the American and European drug regulators (FDA & EMA) felt that the benefits outweighed the risks for dogs taking an SSRI. If we consider that so many humans have died or indeed, been maimed by SSRIs, is drugging your dog really the best option?
Would leaving a child at home alone for many hours justify prescribing them an antidepressant?
There are many mothers, fathers, siblings and spouses who are left bereaved because of an SSRI prescription – who now know what psychotropic drugs can do to the human psyche. It gives a whole new meaning to ‘I wouldn’t give this to my dog’.
Being Irish though one more thought occurs to me. The IRA would probably have had the English out of Ireland long ago if they bombed Crufts Dog Fair, perhaps Pharma are making a bigger mistake agitating our pets than they are agitating us.
- Lilly. Reconcile PIL. In: FDA, editor. Online2007.
Leonie, this is wonderful. There’s almost too much to say …
Last year the USA was hit by ads for a new doggie anti-anxiety med called Sileo. Just in time for the Fourth of July! I found the press release hilariously similar to those for human psych drugs:
“At least one-third of pet owners report that their dog suffers from noise aversion1. Common clinical signs include panting, trembling, cowering, and escape behavior, which can result in self-trauma as well as property damage2. These behaviors disrupt the human-animal bond during noise events, such as July 4th celebrations. In fact, fireworks are one of the top triggers for noise aversion in dogs2 and, as a result, July 5th is the busiest day for shelter intakes in the United States3. (NOTE: Do NOT think this disorder is trivial–it can send a dog to Death Row!)
However, only 40 percent of pet owners seek treatment from their veterinarian; 20 percent look for solutions on their own, while 40 percent of dogs suffering from noise aversion do not receive any treatment2. 69 percent of pet owners are “neutral” to “dissatisfied” with current treatment options: the unmet need is a treatment that provides consistent results without causing sedation or requiring behavior modification2.
Behaviorists agree that untreated noise aversion progresses to a more severe state and the development of other anxieties. “There is no suffering and pain worse for dogs than that caused by fear. Fear deprives dogs of joy and damages relationships,” says Karen L. Overall, MA, VMD, PhD, Diplomate American College of Veterinary Behavior, of Philadelphia, PA. “Behavioral pathology is progressive, so early recognition, diagnosis and treatment are essential.” (So, there are doggie-med Thought Leaders …)
Sileo, or dexmedetomidine, is described as a “highly selective alpha-2 adrenoceptor agonist that blocks norepinephrine release, a chemical in the brain that is involved with the development of fear and anxiety.” Given that so many human drugs intended to treat depression, etc. boost norepinephrine, I question if the dog is feeling all that mellow. Maybe it’s thinking, “Yeah, I could bark — but what’s the goddamn point? What’s the point of anything?”
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Cats too apparently……
3 of the Most Effective Dog Depression Treatments
Dog depression can sometimes be difficult to spot, but it doesn’t have to be hard to treat. If your dog is suffering from depression or anxiety-related issues, these top medications can help.
petcarerx.com
PS Can Anti-depressants be given to horny dogs to chemically castrate them 🙁
Thanks for The Dog, Leonie
I have had two labradors for nearly 25 years, until recently, for the final put down ..
Nothing better than arriving back at the van and the waggy tail at the door, big licks, huge excitement, mama has come home ..
First things first – feed the dog – an hour of walking in Scotland where it has not stopped raining for 300 years – food and exhaustion are the only two things I concentrated on – him to be happy and me to relieve the guilt of having to work all day as a gardener and having to leave him when I couldn’t take him with me – up at seven and do it all over again – every day for nearly 25 years ..
I even doubled up walking my lady gp’s two labradors after walking my own; she needed help as her two dogs were badly trained, jumped up, bit, pulled and didn’t behave like mine – at this time she was ‘treating me’ with Seroxat withdrawal ..
The dog is the antidepressant
https://www.psychologytoday.com/blog/where-science-meets-the-steps/201506/nature-s-antidepressant-the-dog
A vet prescribed my last black lab, Doosker, a drug – apparently for inflammation (of what I know not). I do remember him saying it might be for life, it cost a fortune – a fortune I did not have ..
Give it a go, I thought.
A few days later the van had a hole in the seating the size of a small deer .. my dog had attacked the seating and dug and dug with foam and seating innards everywhere
I knew it was the medication. I knew because I had a deja vu about Seroxat and violence and aggression.
The dog med was chucked and normal service resumed .. lick lick a head weighing a ton dropped on me nothing like a dog hug
Nursing homes encourage dogs to visit – my own mum loved the dogs, the rabbits, and even a guy with snakes and reptiles who came to drape them all over the residents – jeez, they loved it ..
What with kennel cough and annual booster injections, tick ointments, expensive proper dog food, it is expensive to keep a dog, and I dare not think how much a vet would charge for Prozac
The Dog gives back what you give to him and if The Dog decides to throw himself under a train then I think we can decide for ourselves that The Dog had a Stewart moment and we can deliver testimonies that giving our animals anything other than devoted love is the way to go and stuff the antidepressants or unstuff the antidepressants ..
Well, Leonie, I can hardly believe the facts that I’ve just read here. In a comment in response to ‘Alt Medicine’ at the end of August I stated that I wondered where pharma would turn to next, now they’ve exhausted ( in all meanings!) the human race – would it be to our pets. Little did I know that it was already going on.
We, in Wales, are lucky enough to have free prescriptions – therefore fail to realise the heavy cost of repeat prescriptions. I guess that if we start medicating our pets then we’re in for a very nasty cost shock.
Shane’s teeth saga, as he stated has not cost him in money – again due to free NHS dentistry. His dog needed dental treatment recently – the vet quoted £300 to take out ONE TOOTH (plus overnight care if needed). Since Shane had adopted the dog ( yes, that’s the term) from a local rescue centre – who have their own on-site vet facility, he got in touch with them regarding the necessary treatment. They could do it for £80. No need to state which Shane chose of course. The dog was duly taken along and it was found that it actually had 7 teeth which needed to be extracted – all done for the total of £80 plus extra for antibiotics and painkillers. The crafty vet that first brought this to Shane’s attention would have charged his £300 x 7 over the next few years. The reason Shane looked elsewhere was due to his insurance for the dog being ‘accident cover only’. Doesn’t this illustrate exactly the reason why full coverage by pet insurance is so high? This brought home to me exactly how things would turn out for us in the UK if the US style of insurance healthcare was to take hold here.
Back to the dogs – they provide companionship to the lonely and a sense of responsibility and ownership to the young. They are a godsend which come with responsibilities – time is needed to provide the care that they deserve. With training, they enhance the lives of families. They need stability, care and love. They ask for nothing more – and, in my opinion
should be kept well away from any ‘mind altering’ potions of any sort.
From Belinda
When I was in grad school, I worked in a clinic. There I saw two doctors and their patients. One doctor was calm and confident….his patients tolerated their procedures well. The other doctor was quite sure all his patients were anxious and he premedicated them with Valium. This doctor was himself, tense, irritable, and often snippy with staff. I based my dissertation on these observations…that anxious providers prescribed more tranquilizers than their less anxious counterparts.
That dissertation got me my first job, back in the 1970’s in the Dept of Family Medicine at Duke Univ where I taught residents skills to manage their own and their patient’s anxiety. I had to learn about psychopharmacology to protect my own psychotherapy patients who were getting medicated because they may have shed a tear, or complained about their spouses. I needed the information to credibly fight my MD colleagues. My state doesn’t recognize psychologist prescribers and I have never wanted to be in the position to offer drugs I couldn’t trust, so my professional life has focused on educating physicians, psychologists, and patients and encouraging them to be better informed and less passive about what is foisted on them by big Pharma.
Belinda R Novik, MSCP, MD, Ph.D
Licensed Psychologist
Clinical Psychopharmacologist
Chapel Hill, NC
Belinda
Thanks for this. This maps onto what I hear about Vets the whole time. The dog or cat or whatever figures they are now in the hands of someone who is less tense than their owner and they relax. Vets are also good at what used to be called animal hypnosis.
But the other side of this is dogs in particular can often be very good at detecting when we are anxious or ill and good at coming and lying beside us and settling us down. You’d have to wonder if a dog who’s internal signalling systems are scrambled by drugs would be as good at doing this.
David
I suspect the prescribing doctor involved in this dissertation study either never completed his own psychoanalysis and/or wasn’t consciously aware of countertransference.
Interesting article, Leonie. Why would anyone want a pet whose ability to be an active companion was numbed by unnecessary drugs? Perhaps such pet owners are too lazy to walk their dogs.
Kristina
Its not clear that any animals – including humans – are meant to be “stabled”. As I understand it they “give up” when left alone. You’d have to wonder what we are doing with a lot psychotropic prescriptions particularly in children
David
Some more ‘calming products for pets’…
For cats, as advertised in The Veterinarian (Australia) June 2017:
My owner calls me “Pee Diddy”
But I only spray because other cats freak me out.
Cats show stress and anxiety in very different ways – like spraying, scratching and hiding – so it’s important not to misunderstand these signs as bad behaviour. Feliway diffusers are scientifically proven to help calm cats and get them back to their best.
So recommend Feliway and sign up to the complete Ceva Pet Stress Management Program to help get cats and their owners back on the same page.
Feliway – The secret to happy cats.
For dogs, as advertised in The Veterinarian (Australia) July 2017:
Addressing Canine Anxiety with Nutritional Supplements
Fearful dogs, dogs demonstrating signs consistent with ADHD and dogs that are dominant and aggressive have been found to have low concentration of serotonin or tryptophan compared to control dogs not displaying these signs.
What is Tryptophan?
Tryptophan is an amino acid required for protein synthesis, as well as for the production of the monoamine neurotransmitter serotonin responsible for mood (happiness) and sleep. The conversion of Tryptophan into Serotonin is supported by B vitamins.
For a happy and healthy pet
Paw – Pure Animal Wellbeing. Complete Calm Multivitamin Chews with Tryptophan
High levels of L-Tryptophan: A Natural mood regulator
B Group vitamins to maintain normal nervous function
Tasty kangaroo based chew
Developed by vets. Inspired by nature… By Blackmores
Leonie .. Mad in America
https://www.madinamerica.com/2017/10/dogs-and-serotonin/
John Hoggett October 4, 2017 at 3:27 pm
My friend’s cat over grooms her fur. She was offered prozac type drugs for the cat.
Eek.
mik October 4, 2017 at 10:02 pm
Oh dear…and if dogs become aggressive as a result of SSRIs (as many humans do), after attacking and maiming people, other animals, etc they will be labelled vicious and killed.
Sad that we would be encouraged to do this to our beloved furry companions.
Sorry dogs but what about also the suicidal fish.
Antidepressants Found In The Great Lakes And Fish
https://www.forbes.com/sites/brucelee/2017/09/04/antidepressants-found-in-the-great-lakes-and-fish/#3bd5769887db
Male fish have been seen to become obsessive tending to the eggs and in higher SSRI doses have been found to even kill the female fish.
Antidepressants Found In The Great Lakes And Fish
Amazing that they recognise this in fish but not humans. Dogs and Cats must also suffer terribly.
Even the Gorillas and Bears in our Zoos are hooked on Prozac
In 1954 Rhône-Poulenc sold the U.S. chlorpromazine license to Smith Kline, which named the drug Thorazine. The market for the new drug was mind-boggling, generating $75 million in sales in its first year.
https://www.wired.com/2014/07/animal-madness-laurel-braitman/
Dolphins, whales, sea lions, walruses, and other marine creatures in parks like SeaWorld have also been given psychotropic drugs for what their vets see as depression, anxiety, compulsive regurgitation, flank sucking, or other distressing behaviors.
The Gorillas Who Got Haldol, Valium, Klonopin, Zoloft, Paxil, Xanax, Buspar, Prozac, Ativan, Versed, Mellaril, and Beta-Blockers
https://pubs.acs.org/cen/coverstory/83/8325/8325thorazine.html
Of chlorpromazine’s side effects, the most visible is tardive dyskinesia. Causing abnormal and purposeless movements, tardive dyskinesia’s traits are similar to those found in Parkinson’s disease. Early indications that the drug caused Parkinsonian-like symptoms were overshadowed by chlorpromazine’s benefits, but by the 1970s, tardive dyskinesia had drawn enough attention to tarnish the drug’s reputation and diminish its use.
They put Thorazine in the Coca-Cola ..
Not an overly objective piece. A lot of judgemental comments. Quick to blame neurotic and lazy owners – taking the easy way out to help big pharmas push an illness that apparently does not exist. I have two cattle dog puppies. The eldest is 14 months – and I got him at 4 weeks. It was preferable to his little neck being wrung. The youngest 11 months and I got her at 10 weeks. It was preferable to her catching a bullet. She is a bit clingy, but independent and quite well adjusted. He is riddled with issues. My vet and I are discussing serotonin for him. He has the separation anxiety you all dismiss so casually. He is not destructive when I am away – but he will hurt himself in blind panic when I leave. Even when he chooses to go outside and play with the little one – he compulsively comes in to check I am where he has left me. He has never been molly coddled, we have routines in place and we have done hours of training. We can now be in separate rooms and he will have a little cry and then sit/lie at the barrier until we are reunited. 13 months to get this far. We go walking/jogging in the morning if we don’t go cycling (I have a walky dog), we do training, we do obedience and trick training and ‘play’ agility in the afternoons. It has taken 13 months for the ‘stay’ command to get me three steps.We go off lead on the common, or swimming in the river on the weekends (unless they are or have recently baited). They have two canine friends who come over Sunday afternoons. I increase the number times a day I go out, the number of days a week I go out. Sometimes ‘going out’ is taking the bin out to the kerb. It breaks my heart to hear the absolute panic when he thinks I am leaving. He is a lovely, good natured dog. He loves everyone and wants to play with all and sundry. We even have the dog appeasement pheromone diffuser and collar.
He isn’t this way because I neglect him, or abandon him, or am neurotic. Nor am I just too damn lazy. Neither my vet nor myself want to medicate him – but he can’t keep being so distressed every single day. Nor does he deserve to die because he was taken off his mother far to early. Both my vet and I are looking into to medicating him – with the objective being a short time on medication that may settle him enough that training will be sufficient in the future.
Before you write pieces like this – that degrade and devalue animals that don’t do okay – why don’t you try seeing what life is like for them – then scoff at ‘so called separation anxiety’.
If you have children – imagine the tears and fears of the first day of school for the hardest hit of children – and then apply that to your child every time you leave a room and they can’t go with you. It would simply break your heart if you had one. I can only hope someone takes such a callous attitude toward y’all one day. Perhaps then you will get off your high horse and have some compassion for those in need.
I would have agreed with you had your point been the over use of pharmaceuticals and that trend now moving into the veterinary field. Instead your narrow minded expertise simply belittles people who face real issues.
You people – and your opinions are a good lick of the reason people with mental health issues don’t seek help. Bet your momma is proud of you.
Puppies leaving their mother before 10weeks (preferably 12weeks) shouldn’t happen unless extenuating circumstance. And SSRI is not appropriate, ever. Benzodiazepines if you can’t set aside time for cognitive behavioral therapy, if you feel you should, it is your choice.
Behavioral therapy = raising an emotionally, socially and physically stable puppy into adulthood.
Defending pharmacology is interesting.
Being a pharmacologist and life long trainer of NBHA/ACTRA/WPRA horses.. I’m also 3rd generation dog trainer/kennel owner/etc…
Between a big boy kennel and a cattle ranch where we favored border collies for moving herds (they stare prey down causing heard movement)
People are always to blame.
We are adults.
Benzodiazepines are safe temporary pins.
MAOI AND SSRI that’s crazy.
I have good stories of the vets I worked for while in pharma school.. selling so much prescription diet dog food we got outlandish staff vacations.
I also stopped UCdavis in 2014 and a nice nerdy pet nutrition data research department took me in and now I’m a net nutritionist. They didn’t even charge me to learn, good people won’t.
Also dogs use corn as a simple carb, never complex like humans can… it’s a cheap filler and you throw away money.
Sorry if this sounded confrontational Nic, I just don’t understand how paying someone for something sounds more reasonable than simple self responsibility.
Take care
I’ve just read your article and have so many questions, fears and doubts about the subject. Back in December we brought home a puppy, Diesel for the first time from a farmer. The housing they were kept it was appalling but needless to say we brought him home. Diesel was not well or behaving the way a healthy, normal dog does at 8 weeks. Little did I know about fear-aggression and the toll it takes on the animal and the family until his 8 month birthday. I didn’t put his not liking walks and the outdoors with the fear factors. I thought constant exposure would self medicate this situation but only made it worse. I sought veterinary help along with a certified dog trainer for guidance. Our dog trainer suggested to our vet a form of prozac for Diesel. I was dead against it and tried a natural remedy instead. It didn’t help at all. His fear-aggression was only getting worse and my husband stated if we couldn’t get him remedied, we would have to get rid of him. I’ve introduced Diesel to the prozac reluctantly but have found it has helped presently. Before use, Diesel looked lost, sad and uncertain all the time. His tail never wagged. He couldn’t sleep and would keep us up all night panting and pacing. Dogs actually picked on him, it’s like they knew he wasn’t confident or sure of himself but he wanted to meet and play with them,he was just scared. He began nipping, barking and lunging at everyone and everything at 8 months’. He would react from 0-100 in a second. He’s a big boy…a German Shepherd and powerful. I was told the prozac would help with all this and it has somewhat. He wasn’t properly socialized when he was little and I was told part of his brain never developed because he wasn’t socialized and the prozac would give him what he needed until we could retrain the brain with positive reinforcement. I have to say he is sleeping well now, he has clarity in his eyes…no longer looks lost, sad and confused. He gets excited now and his tail wages. He actually smiles now. He doesn’t love walking but he doesn’t hate it anymore either. His reaction time is slower but he still reacts to stimuli. He has overcome some fears but due to the concentration of fears abroad, this may take some time for him to overcome. My dog trainer has just upped his dose to a “therapeutic dose” today. After reading today’s article, I’ve become afraid and concerned about side effects down the road. What are your thoughts?