“There are a few options for treating your depression,” I say to the patient. “But I think this medication may help.”
The patient laughs. “That’s pretty funny, Doctor. My dog takes the same pill!”
The interface between pets and mental-health care has been a hot-button issue in recent years. The evidence that therapy animals can help treat people with psychiatric issues is patchy, yet emotional-support animals seem to be everywhere.
Meanwhile, veterinary providers and pet owners are paying increased attention to such problems as separation anxiety, compulsive behaviors, phobias and aggression in pets. As a result, many American pets take psychiatric medications.
“I think the increased use of psychoactive drugs comes from acceptance, even in the scientific community, that it’s OK to talk about fear, stress and anxiety in animals,” said Carlo Siracusa, a clinical assistant professor of behavior medicine at the University of Pennsylvania School of Veterinary Medicine.
On the basis of a 2017 national survey, the market research firm Packaged Facts concluded that 8 percent of dog owners and 6 percent of cat owners gave medications to their pets for anxiety, calming or mood within the previous 12 months. Because about 60 million American households own dogs and 47 million households own cats, according to one estimate, these figures suggest that millions of animals in the United States are taking medications for behavioral issues.
Some versions of human medications have received approval by the Food and Drug Administration for specific mental-health uses in pets, including the antidepressant clomipramine (Clomicalm) for separation anxiety in dogs, the sedative dexmedetomidine (Sileo) for dogs with noise-aversion problems, and selegiline (Anipryl), a drug often used to treat Parkinson’s disease in humans, for canine cognitive dysfunction.
However, many if not most of the psychiatric medications given to pets are being used off-label — that is, for conditions other than those the drugs were approved to treat. A survey of small-animal veterinarians published in 2016 found that 83 percent had prescribed the antidepressant fluoxetine (aka Prozac) to cats and/or dogs, often for treating inappropriate urination and aggression. Owners have written about giving common psychiatric drugs such as buspirone, trazodone and alprazolam (Xanax) to their pets. An article for the website the Daily Puppy publicizes risperidone, an antipsychotic used in humans for treatment of schizophrenia and bipolar disorder, as “improving your dog’s behavior.”
Whether pets need mood-altering drugs remains controversial. Nicholas Dodman, a professor emeritus at the Tufts University Cummings School of Veterinary Medicine and author of “Pets on the Couch,” has written that animals experience behavioral disorders similar to those of humans and that pets may need medications to alleviate their suffering. Treating these conditions, Dodman says, might also prevent some pets with behavioral issues from being sent to shelters or from being euthanized.
Siracusa said the use of psychiatric drugs in veterinary medicine represents a shift away from poorly regulated “punishment-based behavior modification” such as shock collars for dogs that bark too much. “If you have to use a psychoactive drug, you have to talk to a vet, right?” he said. “If you have to use the shock collar, you just go on Amazon and buy it yourself,” he said, adding the drug is probably more benign than other things people do to animals.
Critics of giving pets psychiatric medications argue that owners should rely on behavioral approaches, such as spending time with pets, taking them outdoors and training. Research supports the idea that environment plays a role in behavioral issues. Studies suggest that dogs who are walked only a few times a week or whose owners spend less time at home may be at greater risk for behavior problems.
Giving these kinds of drugs to pets isn’t risk-free. Just as with humans, psychiatric medications for pets can carry plenty of side effects, including gastrointestinal upset, weight changes and irregular heartbeats.
Pets undoubtedly have mental-health needs that deserve attention. But as a doctor specializing in mental-health care for people, I’ve learned that prescribing psychiatric medications often comes with uncertainty. I can only imagine how hard it must be when the patients cannot speak their minds.
Morris is a resident physician in psychiatry at the Stanford University School of Medicine.