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.
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.