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Nuts and Bolts of Anxiety Meds: Medicine can help bad behavior and anxiety, but be sure the treatment doesn't cause more headaches.

While some feline behavior problems can be resolved at least partially with environmental management strategies, sometimes medication becomes necessary. This is often due to behaviors that pose a risk to the cat, owner, or other pets in the household, or may be to simply break the cycle of a very stressed cat. Before you ask for an anti-anxiety medication, you should understand what the drug does and how to use it.

Seeing Results

Many behavioral medications need several weeks to build up sufficient levels in the cat's system to show effects. If your situation requires more immediate results, your veterinarian may choose a different medication or may initially prescribe two medications for your cat: the one that he or she wants your cat to be on long-term and another that will start working immediately to provide relief while the other medication is building up in the system.

Always follow prescription instructions closely. Cats are sensitive to many medications and giving too much or too frequently often could cause an overdose. Likewise, not giving the medication on the recommended schedule could decrease its effectiveness.

If you have trouble medicating your cat, tell your veterinarian your concerns. Pill guns and pockets are useful for getting pills into cats, but you also can investigate different formulation options that may be more appealing to your cat. Some medications can be compounded with flavoring, such as catnip or chicken. Others can be sprinkled on your cat's food or made into a gel that can be absorbed through the skin on your cat's ear. If you can't give a medication twice a day, ask about once-daily alternatives.

Types of Medication

The five classes of drugs used most commonly for feline anxiety disorders are azapirones, benzodiazepines, monoamine oxidase inhibitors, tricyclic antidepressants, and selective serotonin reuptake inhibitors.

Azapirones stimulate serotonin receptors and block some adrenergic receptors. Serotonin levels have been linked to depression and anxiety, and adrenergic receptors stimulate fight-or-flight behaviors. Stimulating serotonin can be beneficial for your cat's mental state, while blocking adrenergic receptors helps to keep her calm. Azapirones are not addictive and have a low potential for abuse by humans.

Benzodiazepines enhance the effects of gamma-Aminobutyric acid (GABA), a neurotransmitter that causes sedation and muscle relaxation, among other things. These medications work fast but also have a potential for abuse.

Monoamine oxidase inhibitors (MAOIs) allow the neurotransmitters serotonin, dopamine, and norepinephrine (adrenaline) to stay active within the brain longer (monoamine oxidase removes these neurotransmitters).

Tricyclic antidepressants (TCAs) also prevent the removal of serotonin and norepinephrine from the brain.

Selective serotonin reuptake inhibitors (SSRIs) work by preventing the removal (or reuptake) of serotonin within the brain. One of the advantages to these medications is that they seem to specifically target serotonin, while other neurotransmitters are unaffected.

Every medication has the potential for drug interactions, so it is important to notify your veterinarian of any and all medications and supplements that your cat may be taking.

Depending on the cause and severity of your cats anxiety disorder, anti-anxiety medication may be a short-term solution to alleviate symptoms while you make adjustments to his environment to decrease stress, or it may be a long-term medication that he receives for the rest of his life. With most long-term medications, your veterinarian will want to do bloodwork every six to 12 months to monitor liver and kidney function. This regular bloodwork is important to make sure that the medication is not impacting the rest of your cat's body in a negative way and allows you to catch any developing problems early.

Caption: A cat who is unnecessarily anxious may be helped by an anti-anxiety medication.
Feline Anti-Anxiety Medications

Medication        Useful Information         Side Effects
Drug Class

Alprazolam        If being used to calm      Sedation, irritability,
(Xanax),          the cat during specific    depression, increased
Benzodiazepine    events or triggers, it     appetite, temporary
                  should be given 30 to      balance/mobility
                  60 minutes beforehand.     issues; should be used
                  Usually in tablet form,    with caution for cats
                  but can be compounded      with liver or kidney
                  as a liquid suspension.    disease.

Amitriptyline     Can be given once or       Sedation, constipation,
(Elavil),         twice a day. May take      urinary retention,
Tricyclic         weeks to see results.      excessive drooling,
antidepressant    Make sure the cat has      anorexia, vomiting,
                  access to plenty of        clotting disorders,
                  water. Dosage must be      irregular heartbeat;
                  tapered if you             should be used with
                  discontinue this           caution for cats with
                  medication.                seizure disorders.

Buspirone         Given 2 to 3 times a       Behavioral changes such
(BuSpar),         day. May take a week or    as increased affection
Azapirone         longer to see results.     and assertiveness;
                  Can be given on an         should be used with
                  empty stomach, but if      caution in cats with
                  the cat vomits, the        liver or kidney
                  owner should try giving    disease.
                  it with a meal.

Clomipramine      Given once a day. May      Vomiting, diarrhea,
(Clomicalm        take several weeks to      sedation, dry mouth,
and Anafranil),   see results and is         increased heart rate,
Tricyclic         most effective when        urinary retention,
antidepressant    used with behavioral       constipation; should be
                  management. Dosage is      used with caution in
                  usually started low and    cats with seizure
                  then gradually             disorders, liver or
                  increased and should be    kidney disease,
                  tapered if the             arrhythmias,
                  medication is              constipation, or
                  discontinued. Can be       urinary retention.
                  given with or without
                  food. Avoid giving your
                  cat aged cheeses while
                  he is on clomipramine.

Clonazepam        Longer-acting than most    Sedation, ataxia, liver
(Klonopin),       benzodiazepines. Dosage    problems, increased
Benzodiazepine    should be tapered if       appetite; should be
                  discontinuing. If using    used with caution in
                  to calm a cat during       cats with liver
                  specific events or         disease, narrow angle
                  triggers, it should be     glaucoma, or
                  given an hour              myasthenia gravis.
                  beforehand. Can be
                  compounded in a liquid

Diazepam          Should not be given to     Sedation, ataxia, liver
(Valium and       cats who have been         failure, irritability,
Diastat),         exposed to the             depression, increased
Benzodiazepine    pesticide chlorpyrifos.    appetite; should be
                                             used with caution in
                                             cats with liver or
                                             kidney disease. Because
                                             of the potential for
                                             liver problems,
                                             diazepam is
                                             controversial for use
                                             in cats.

Fluoxetine        Given once a day. Can      Anxiety, irritability,
(Prozac and       be given with or           altered sleep cycles,
Reconile),        without food. May take     anorexia, altered
Selective         several weeks to see       elimination patterns;
serotonin         results. When              should be used with
reuptake          discontinuing, dosage      caution in cats with
inhibitor         should be tapered          diabetes mellitus,
(SSRI)            gradually.                 seizure disorders, or
                                             liver disease.

Paroxetine        Given once a day. May      Anxiety, irritability,
(Paxil), SSRI     take days to weeks to      altered sleep
                  see results. When          schedules, anorexia,
                  discontinuing, dosage      constipation, altered
                  should be tapered          elimination patterns;
                  gradually. Avoid flea      should be used with
                  collars while giving       caution in cats with
                  paroxetine.                heart, kidney, or
                                             liver disease.

Selegiline        Given once daily,          Vomiting, diarrhea,
(Anipryl,         usually in the evening     restlessness, lethargy,
l-depenyl,        for cats. May take         drooling, anorexia,
Eldepryl),        several weeks to see       hearing loss, itching,
Monoamine         effects. It is FDA-        licking, tremors.
oxidase           approved for cognitive
inhibitor         dysfunction syndrome in

Sertraline        Given once daily. May      Sedation, anorexia,
(Zoloft), SSRI    take weeks to months to    vomiting, diarrhea,
                  see results. When          irritability, anxiety,
                  discontinuing, dosage      altered sleep
                  should be tapered          schedules; should be
                  gradually. Avoid flea      used with caution in
                  collars while giving       elderly cats or those
                  sertraline.                with liver disease.
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Title Annotation:DISEASE
Publication:Cat Watch
Date:Oct 1, 2018
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