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Fluoxetine to Treat Aggression and Anxiety Disorders in Dogs and Cats

   Fluoxetine is an SSRI antidepressant used to treat a variety of anxiety disorders in animals. In dogs, fluoxetine is primarily used for ritualistic stereotypical behaviors, aggression, and anxiety disorders.  Fluoxetine may also be beneficial in cats that demonstrate urine-spraying, compulsive grooming, or aggressive behaviors. Fluoxetine is not a tranquilizer or sedative and works by treating the underlying cause of neurotransmitter imbalance. Anxiety and behavioral problems usually begin to resolve within 3 to 4 weeks of initiating fluoxetine when used in conjunction with a behavioral modification plan.
       
   Fluoxetine has fewer anticholinergic side effects (such as blurred vision, dry mouth and dizziness) and a wider margin of safety than other antidepressants. However, potential adverse effects in dogs include anorexia, GI upset, and lethargy or restlessness; and in cats, fluoxetine has been reported to cause decreased appetite, irritability, sleep disturbances, and changes in elimination patterns. Fluoxetine should not be used in dogs with seizure disorders or with drugs that lower the seizure threshold.  Fluoxetine also should not be used in pets also on monoamine oxidase inhibitors (such as selegiline) or who have used tick collars containing amitraz within the last 14 days. Fluoxetine should be used cautiously in animals with liver dysfunction.
 
   While fluoxetine is commercially available for humans in multiple strengths of tablets and capsules, these formulations may not work for many animals and are not your only options. Our compounding pharmacists work with pet owners and their veterinarians to customize preparations that suit each animal’s needs. For “easy-to-pill” cats and dogs, we can compound capsules in strengths that are not commercially available. For patients that do not tolerate the administration of capsules or tablets, our compounding pharmacists can offer other options, including flavored oral suspensions in a variety of different concentrations depending on the size and needs of each patient. We can also compound fluoxetine as an easy-to-administer transdermal gel that can be applied to the inside of the ear flap. Like all transdermal gels, pet owners should alternate ears with each dose and to wipe off excess gel immediately before the next dose, and wear a finger cot when applying medication to prevent absorption of medication by the pet owner.

References

Adams, R. H. (2009). Veterinary pharmacology and therapeutics (9th ed.). Ames, IA: Iowa State University Press.
American Journal of Veterinary Research 64 (8): 994-998.
Plumb, D.  Veterinary Drug Handbook. Ames, Iowa: Wiley-Blackwell, 2015.


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