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Psychotropic Agents for Integumentary Disease

By Michael Shipstone, BVSc, FACVSc, DACVD, Queensland Veterinary Specialists

Psychotropic drugs have been used extra-label for treatment of feline psychogenic alopecia and canine acral lick dermatitis, syndromes characterized by excessive self-licking (also see Abnormal Repetitive Behaviors and Feline Compulsive Disorders). Classes of drugs used include antidepressants, antipsychotics, opiate antagonists, anxiolytics, and mood stabilizers (see Table: Psychotropic Drugs Used for Skin Disorders).

Psychotropic Drugs Used for Skin Disorders

Drug

Dosage

Antidepressants

Clomipramine

Dogs: 1–3 mg/kg, bid

Cats: 0.5–1.5 mg/kg/day

Amitriptyline

1–3 mg/kg, bid

Doxepin

0.5–2 mg/kg, bid

Fluoxetine

1 mg/kg/day

Anxiolytics

Diazepam

1–2 mg/kg, bid

Phenobarbital

0.5–2.2 mg/kg, bid; 15 mg/cat, twice weekly

Hydroxyzine

2.2 mg/kg, tid

Opiate Antagonists

Naltrexone

2.2 mg/kg/day

Sedation is the most common adverse effect of diazepam. It is also an appetite stimulant in cats. Idiosyncratic fatal hepatic necrosis has been reported in several cats treated for as little as 8–14 days. Tricyclic antidepressants are potent H1 blockers in addition to inhibiting uptake of serotonin and norepinephrine. These drugs can induce cardiac arrhythmias and lower the seizure threshold. Other adverse effects include dry mouth, hypersalivation, vomiting, constipation, urinary retention, ataxia, disorientation, depression, and anorexia. Tricyclic antidepressants should not be used concurrently with monoamine oxidase inhibitors, including amitraz dips for demodicosis. Dosages should be tapered slowly when discontinued.

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