Reconcile, Prozac for dogs

prozacfordogs

Fluoxetine hydrochloride (3-(p-trifluoromethylphenoxy)-N-methyl-3-phenylpropylamine HCl) was first described in a scientific journal in 1974 as a selective serotonin -uptake inhibitor.  It was licenced for use in the treatment of depression in Belgium in 1986 and the USA in 1987.  Before its launch, to introduce it to the public, its manufacturer Eli Lilly funded eight million brochures (“Depression: what you need to know”) and 200 000 posters.  It would become one of the best selling pharmaceuticals of its age; by 1992 annual sales had reached US$1bn and by 1995 they had doubled to US$2bn.  In 1999 ‘Prozac’ – the trade name of fluoxetine – was named on of the ‘Products of the century’ by Fortune magazine.

The impact of the drug is hard to overstate, both in terms of the culture of the treatment of mental health disorders and in Western society at large.  Prior to the introduction of fluoxetine antidepressants had a reputation of having side effects and were cautiously prescribed as they were toxic in overdose.  Fluoxetine, on the other hand, was relatively benign and its introduction practically created a market in drugs for mood problems that could be safely prescribed to anyone who wanted them.

Other SSRIs followed in fluoxetine’s wake and the result has been an explosion in the diagnosing of depression and the prescribing of antidepressants.  This is all the more incredible when one considers that the revenue from antidepressants sales in 1975 was US$200million and the market was considered to be saturated.  ‘Prozac’ has since entered the popular lexicon and spawned its own sub-genre of literature.  Of these perhaps the best known is Prozac Nation, a bestselling – but in my view rather tedious – memoir of mental illness written by Elizabeth Wurtzel.

There have been some hiccups along the way.  Fluoxetine doesn’t have as few side effects as originally thought and, amongst those who are prescribed it, anorgasmia is quite common.  Nausea is often experienced initially and it can sometimes increase rather than reduce anxiety.  There have been concerns about other SSRI drugs, notably paroxetine, increasing suicide risk in young adults and in 1989, Joseph Wesbecker shot and killed eight people and injured 12 others in Kentucky before killing himself.  More recently a meta-analysis of 35 clinical trials of four antidepressants including fluoxetine concluded that the action of the medications was not clinical significance for any patient who was not severely depressed.

In 2007 Eli Lilly began to market fluoxetine for dogs under the name Reconcile.  In this incarnation it’s chewable, tastes like beef and is intended to treat something called ‘canine separation anxiety’.  This disorder amounts to a set of behaviours displayed by a dog when being left alone for too long.  A dog so affected may urinate in inappropriate places or chew furniture.  At the time of launch Lilly said that their research showed the up to 17% of dogs suffered from this behavioural disturbance.  Reconcile comes in a once a day chewable beef flavoured capsule.

I don’t know much about dogs, but other people seem to really like them.  I’ve been trying to think about what antidepressants for dogs tells us about ourselves.  Many people see dogs as part of their families and as such project onto them human attributes.  In their advertising Lilly avoid suggesting that Reconcile is a treatment for ‘canine depression’ but other articles written at the time of Reconcile’s launch are not so careful, here in the Times:

In Britain, research among pet-owners carried out for Sainsbury’s Bank in 2003 indicated that 632,000 dogs and cats had suffered from depression in the previous year.

Nearly three times as many pets had suffered from behavioural problems that which could be linked to depression, often resulting in the animal damaging its home or becoming moody or aggressive, according to the research.

The experience of a human disease such as depression involves complex human attributes such as thoughts, emotions and language.  To suggest that we can extend the concept of a specific human mental illnesses such as depression to dogs is to stretch the paradigm almost to breaking point and shows at once how loosely lay people apply the concept and how engrained widespread mental illness it is in everyday thinking.

Not that this association will worry the pharmaceutical companies.  Marketing antidepressants to dogs tacitly encourages dog owners to consider that their dogs have mental health conditions previously described in humans and this can only be good for sales.  Many pharmaceuticals develop mission creep whereby manufacturers endeavor to win them licences to allow their use to treat disorders distinct from those for which they were initially licenced.  Initially cleared for depression only, Fluoxetine is now used for anorexia and bulimia nervosa, obsessive compulsive disorder, panic disorder, premenstrual dysphoria and generalized anxiety disorder.  Viewed in this light, the launch of Reconcile, and fluoxetine’s crossing of the species barrier, is just part of the drugs product lifecycle.

This is not to say of course that fluoxetine doesn’t have its uses for animals.  In similarity to human subjects it may have impressive effects in some, moderate for others and no effect for a substantial number.  The emphasis is on the problem being in the dog and nowhere else,  just like in humans.

Links:

Animals can model psychiatric symptoms – Psychiatric news 2003
Pooches Pop Prozac to Treat Behavioral Problems
Prozac for your dog – Technology Review 2007
Eternal Sunshine – Observer May 2007

Emotions in animals – Wikipedia

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18 Responses to “Reconcile, Prozac for dogs”

  1. I’m glad I’m not the only one who thinks Elizabeth Wurtzel is a pain in the arse.

    Cats can and do suffer from anxiety for various reasons – usually separation anxiety when the owner is absent, or anxiety where there is tension with another cat in the household. When this happens, they can overgroom, which results in them ending up with bald patches and skin problems. So you could claim that cats self-harm out of anxiety. (You’ll also get them peeing in inconvenient places).

    Vets will sometimes prescribe (tiny amounts of) diazepam for this, as well as giving advice on how to calm down the cat. Less drastic are the “feliway” hormone diffusers that send out a continuous stream of calming cat hormones.

    Whether fluoxetine would do much good is a different matter, however. I’d imagine feline brain chemistry is rather different, and in any case, vets don’t know quite THAT much about it, since cats can’t talk.

  2. Zarathustra says:

    Quite agree with you about Elizabeth Wurtzel’s book. I read it when I was 18 and thought she came across as an annoying prima donna.

    Cats certainly do get separation anxiety. My mum’s (sadly now-deceased) cat used to become visibly distressed if the suitcases were taken out of the attic, because he’d worked out that meant my parents were about to disappear for a few days.

  3. FP says:

    Okay, I don’t argue that cats can appear aroused in a way that, if they were human, you might describe as being ‘anxious’.

    However we have no way of knowing a cat’s inner emotional state and to even consider that they have an ‘inner emotional state’ is to project onto them human characteristics. Anxiety is a poorly defined, one definition is ‘a fear in the expectation but not certainty of an unpleasant experience’; to assign this to a cat in a meanful way is to seriously stretch the concept.

  4. Rita says:

    “we have no way of knowing a cat’s inner emotional state” – or any other being’s, including fellow humans, either. Are emotions human – and only human -characteristics? Surely they’d have to be a lot better defined before we could declare that. At the moment, all we have are surmises about the commonality of human emotions – which may well be strongly cultural, to boot – and observations of reactive behaviour in situations which we (think humans) connect emotions with events, and that we see in just about evey sentient being.
    “The experience of a human disease such as depression involves complex human attributes such as thoughts, emotions and language.” Pity no-one told Harry Harlow or Martin Seligman that.

  5. FP says:

    I would agree with you that any argument we have hinges on the definitions we promote.

    The idea of whether animals can feel emotions is oft debated. I am clearly not an expert. When asking about whether an animal is experiencing a ‘human like’ emotion. Two questions to ask:

    - how do you tell?
    - if so, what does it mean?

    We cannot obtain spoken answers but in the absence of this we assume anthropomorphism. On the other hand we do know ‘inner emotional states’ from humans because we can tell one another.

  6. Rita says:

    “On the other hand we do know ‘inner emotional states’ from humans because we can tell one another.”

    Errr- “know” ? “tell one another” ? well, we can try to tell one another about emotional states unknown in our culture (“song” experienced by the Ifaluk, e.g.)or our time (accidie, experienced in the Middle Ages) (Edwards, in Wetherell, Taylor and Yates, 2001, pp238/41) although we can’t experience them, and those we think we can experience we can’t reliably convey (or know we have reliably conveyed) to someone else.

    There is so much work – Kaak Panskepp, e.g., on animal and human emotion going on, it seems a shame to throw out superficialities like “projecting human characteristics onto animals” without at least trying to unpack the relationship of any animal (including the human being) to the whole emotional field.

  7. Rita says:

    Jaak, P. – sorry

  8. I think you’ll find that we agree.

    Vets have observed two cases where cats exhibit behaviour which mimics some forms of anxiety in humans. Your average vet is mainly concerned with fixing the problem, rather than theorising about what the cat is feeling internally (although of course, he or she will seek to minimise pain or distress to the animal). So, they will use the term “separation anxiety” or “anxiety” as a label for the state they have observed in the cat because they have to call it something and this is handiest, rather than because they are anthropomorphising.

    Then they advise the owner how to make the cat feel more relaxed, suggest a Feliway diffuser, additional litter trays, and in extreme cases, prescribe tiny doses of diazepam.

    It’s a ridiculous leap of faith to suggest fluoxetine would be much good, unless there’s a raft of clinical data to the contrary.

    (Disclaimer, I am not a vet, although I know several).

  9. Prozacville says:

    Canine Separation Anxiety: file under Projective Identification methinks (anyone want to update the Wikipedia article?).

    That said, tis a fine beefy flavour, Reconcile. I sometimes use it as a stock cube when making soup.

    http://www.prozacville.co.uk/2010/01/got-kick-for-dog-begging-for-love-i.html

  10. Blammo says:

    FP, I find it kind of absurd that you can’t conceive of animals having something approximating human emotions without attributing it to a “projection” by the owner.

    Perhaps I’m biased. I have a dog that I love dearly, but let me put this to you from another angle: Do you agree that a dog can be excited? Start out in a calm state, then with the introduction of a stimulus that the dog finds desirable (for this example lets say their owner returning from a period of separation), that the dog could feel excitement? Having witnessed such behavior I certainly do.

    Now, is it so hard to make the logical leap that the dog could feel anxiety at the prospect that this desirable stimulus could be removed permanently? I understand where you are coming from insofar as the dog has no idea what anxiety is, but I believe that an animal that has such a close relationship with humans as canines do that it is quite possible, if not certain, that a dog could feel the potential loss of this stimulus as undesirable, and therefore become anxious when confronted with separation from it.

    Emotion is not exclusive to humanity. To think so is arrogant and naive at best.

  11. Mark Browi says:

    After 4 years of battling an extensive allergy problem with my dog, she also developed and OCD licking/chewing issue (probably because her skin itched so much). With reluctance, we started her on Prozac generic. It has been 30 days and I RARELY see her traumatize herself to the point of bloody anymore.

    I am not on any medications, go to a naturopath, believe that doctors over prescribe and patience over indulge in behavior modification. I truly believe that our society is not conducive to humans and the push to be “normal” is actually a push to adapt to abnormalcy. Either way, it is reality and I believe these drugs have their place due to… “it is what it is”.

    Anyhow, the Prozac is there to aid us in finding a cure for her allergies. She is going to a Chinese Herbalist and we have drastically changed her food (raw). In the end, I hope that she will come off the Prozac when the allergies have been “controlled”. We will see…

    If this plan is successful, I will be a supporter of Prozac as treatment to dogs. She seems to have zero side effects.

  12. Ken Smith says:

    I think medication is the last resource to use in our dog, if your dog is suffering separation anxiety, is much better to take him out for a walk on a daily basis, so he gets his head thinking on other stuff than anxiety

  13. Tony says:

    Well that’s torn it! My dog was reading this with me and the look on his face said “you better get me along to the doctor real quick, I want some of those doggie pick me ups” I’m sure that’s what that look meant.

  14. Steve says:

    Prozac’s Old Skool. It’s all about Mindfulness now: http://www.shambhalasun.com/sunspace/?p=21322

  15. David says:

    “The experience of a human disease such as depression involves complex human attributes such as thoughts, emotions and language. To suggest that we can extend the concept of a specific human mental illnesses such as depression to dogs is to stretch the paradigm almost to breaking point”

    Sure, I believe animals have some kind of emotions, however…

    Some times new “diseases” and “pre diseases” terms are made up and of course must be medicated.

    I would say it was about marketing. Eli Lilly would be looking for additional sub markets and decided to extend the drugs to the treating of animals.

  16. Timothy says:

    I had considered buying Reconcile for my dog. However I don’t know if I will be doing it more hard than good. The dog looks down, however it does not talk and so I cannot tell for sure. My vet told me there is nothing unusual with the dog so in the end I ended up not buying the Reconcile.

    Timothy Cassar

  17. david M says:

    My dog suffers from SAD in the winter and I considered buying a light box for him. My vet didnt agree and suggested an anti-depressant. I’m not sure how safe this would be long term.

  18. Roy says:

    Psychiatrists have little or no understanding of human psychology, let alone that of cats and dogs. Every time a drug is prescribed such as Prozac it is a human experiment, and the sale of a profitable overpriced drug. Or in the case of animals an animal experiment.