Psychotropic drugs have been used in an extralabel manner for treatment of feline psychogenic alopecia and canine acral lick dermatitis, syndromes characterized by excessive self-licking (also see Abnormal Repetitive Behaviors and ). 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, PO, q 12 h |
Cats: 0.5–1.5 mg/kg, PO, q 24 h | |
Amitriptyline | 1–3 mg/kg, PO, q 12 h |
Doxepin | 0.5–2 mg/kg, PO, q 12 h |
Fluoxetine | 1 mg/kg, PO, q 24 h |
Anxiolytics | |
Diazepam | 1–2 mg/kg, PO, q 12 h* |
Phenobarbital | Dogs: 0.5–2.2 mg/kg, PO, q 12 h Cats: 15 mg/cat, PO, twice weekly |
Hydroxyzine | 2.2 mg/kg, PO or IV, q 8 h |
Opiate Antagonists | |
Naltrexone | 2.2 mg/kg, PO, q 24 h |
*Repeated PO dosing of diazepam is not generally recommended in cats due to risk of hepatotoxicity | |
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 few 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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Also see pet health content regarding drugs used to treat skin disorders.
