(for veterinary information only)
BRAND NAME: RECONCILE, PROZAC
HOW THIS MEDICATION IS USED
It should be noted that the treatment of behavior disorders requires training in addition to medication. 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 effects of fluoxetine in dogs and cats use is drowsiness or lethargy, but the opposite is also reported: hyperactivity, panting (dogs), irritability, and/or insomnia. Appetite reduction has also been described. Some dogs (approximately 1 dog in 3) will show some degree of weight loss which should not exceed 15% of their original body weight.
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 selegiline, 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 selegiline 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
Fluoxetine lasts a long time in the body. If planning to discontinue fluoxetine, a tapering course is not necessary unless the patient has been taking fluoxetine for more than 8 weeks. In that case, tapering the dose over a couple of weeks is a good idea.
Fluoxetine and MAO inhibitors should not be given together and a "wash out" period is needed between them. If one wishes to begin an MAO inhibitor (selegiline for cognitive dysfunction or amitraz for parasite control) in a patient presently on fluoxetine, a 5 week period is recommended between the last dose of fluoxetine and the first dose of the MAO inhibitor. Similarly, if a patient is on an MAO inhibitor and will be beginning fluoxetine, a two week period is needed between medications. The period is longer in the former incidence because of the very long half-life of fluoxetine in the body.
Page posted: 4/13/2018