(for veterinary information only)
BRAND NAME: RECONCILE, PROZAC
HOW THIS MEDICATION IS USED
Fluoxetine has been used in many animal behavior issues: inappropriate urine marking in both dogs and cats, separation anxiety, compulsive chewing, circling, and self-mutilation, even aggression. Eli Lilly released a product approved for dogs (Reconcile®) in 2007. This product is specifically approved for the treatment of separation anxiety.
It should be noted that the treatment of behavior disorders requires training in addition to simply giving the pet a medication. In the instance of separation anxiety, Lilly has trademarked the B.O.N.D. training program (for details visit www.reconcile.com). Our on-line web library also has information (see link above). When medication and treatment were combined, 42% of dogs with separation anxiety showed improvement by the end of the first week and 73% were improved within 8 weeks.
Fluoxetine is usually given once daily.
It is important to understand that whenever an anti-anxiety medication is used, the phenomenon of “disinhibition” is possible. What this means is that an animal’s inhibitions about aggressive behavior may be reduced when his or her anxiety over the consequences of such behavior is removed. An animal that was not previously aggressive could potentially become aggressive.
The most common side effect of fluoxetine use is drowsiness or lethargy, but the opposite is also reported: hyperactivity, panting (dogs), and/or insomnia. Appetite reduction has also been described.
Appetite reduction is a common side effect of fluoxetine in the dog. Approximately 22% of the dogs in the Reconcile® licensing studies showed 5-10% weight loss on this medication while 6% showed 10-15% weight loss. In other words, these dogs lost 5-10% or 10-15% of the initial body weight while taking fluoxetine.
Some patients will experience an upset stomach with this medication.
INTERACTIONS WITH OTHER DRUGS
Serotonin syndrome is a potentially dangerous situation that can result when serotonin levels get too high. Elevated heart rate, tremors/shivering, dilated pupils, difficulty breathing, elevated body temperature, hyperactivity, and/or high blood pressure can all be signs of serotonin syndrome. Fortunately, the development serotonin syndrome generally requires a combination of at least two serotonin-increasing drugs and rarely happens spontaneously with one medication but it is important to be aware of the symptoms as the high blood pressure can be life-threatening if severe enough. Using MAO inhibitors in conjunction with fluoxetine could create serotonin syndrome. MAO inhibitors are rarely used in veterinary patients with the exception of seligiline, a drug used for cognitive dysfunction in dogs, and amitraz, an anti-parasite topical which is used in several tick control products (see our tick product comparison chart) as well as in Mitaban® dip which is used against mange. Fluoxetine should not be given in conjunction with a Monoamine oxide inhibitor (“MAO inhibitor”) such as seligiline or amitraz.
Cyproheptadine, an appetite stimulant, may decrease or even reverse the effect of fluoxetine.
Fluoxetine should not be used in combination with drugs that could increase the likelihood of seizures (such as acepromazine).
Insulin requirements may be altered in the presence of fluoxetine.
CONCERNS AND CAUTIONS
Page posted: 1/29/2016