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==Introduction==

==Introduction==

In most cases of [[Feline Problem Behaviour|feline behaviour problems]], environmental modification alone is enough to resolve the problem. [[Feline Fear and Stress|Anxiety, fear and stress]] can be treated effectively using conventional methods such as desensitisation and counter-conditioning, or by allowing the cat to perform avoidance behaviour.  

In most cases of [[Feline Problem Behaviour|feline behavioural problems]], environmental modification alone is enough to resolve the problem. [[Feline Fear and Stress|Anxiety, fear and stress]] can be treated effectively using conventional methods such as desensitisation and counter-conditioning, or by allowing the cat to perform avoidance behaviour.  

The basis of using psychoactive medication in the treatment of behavioural problems in cats is to alter emotional and behavioural responses to situations and events in order to promote adaptation.  

The basis of using psychoactive medication in the treatment of behavioural problems in cats is to alter emotional and behavioural responses to situations and events in order to promote adaptation.  

For example:

For example:

*Reducing anxiety so that the individual is less stressed, better able to make better use of its environment and interact socially.

*Reducing anxiety so that the individual is less stressed, more able to make better use of its environment and interact socially.

*Reducing compulsive motivation so that the cat is able to perform a wider range of normally motivated behaviours.

*Reducing compulsive motivation so that the cat is able to perform a wider range of normally motivated behaviours.

*Reduce impulsiveness

*To reduce impulsiveness.

*Reduce specific fear, so that the cat is less avoidant of fearful stimuli and better able to become desensitised.

*Reduce specific fear, so that the cat is less avoidant of fearful stimuli and better able to become desensitised.

It must be remembered that all of the current psychoactive medications licensed for use in humans have been discovered using testing in animal models of anxiety, fear, phobia, compulsion etc. Almost all have been tested in small animal species that are kept as pets, particularly rodents and dogs. This does not mean that clinically effective doses are known for these species, or even that equivalent behaviour disorders are naturally occurring in them. However, it has provided support for the use of psychoactive medications in veterinary patients which has ultimately led to licensing of some products for veterinary use.

It must be remembered that all of the current psychoactive medications licensed for use in humans have been discovered using testing in animal models of anxiety, fear, phobia, compulsion etc. Almost all have been tested in small animal species that are kept as pets, particularly rodents and dogs. This does not mean that clinically effective doses are known for these species, or even that equivalent behaviour disorders are naturally occurring in them. However, it has provided support for the use of psychoactive medications in veterinary patients which has ultimately led to licensing of some products for veterinary use.

Typical situations in which psychoactive medication can be a useful adjunct to behavioural modification techniques include:

'''Typical situations in which psychoactive medication can be a useful adjunct to behavioural modification techniques include:'''

:*When fear or anxiety are very intense and is interfering with learning and the response to behavioural therapy.

:*When fear or anxiety are very intense and are interfering with learning and responses to behavioural therapy.

:*Where conditions eliciting fear or anxiety are unavoidable in normal life.

:*Where conditions eliciting fear or anxiety are unavoidable in normal life.

:*Where chronic anxiety or repeated fearful experiences are impairing the animal's welfare.

:*Where chronic anxiety or repeated fearful experiences are impairing the animal's welfare.

:*Where distraction is difficult (e.g. severe stereotypy/compulsion).

:*Where distraction is difficult (e.g. severe stereotypy/compulsion).

:*If speed of recovery is critical (threat of legal action, eviction etc).

:*If speed of recovery is critical (threat of legal action, eviction etc).

:*Where safety may be improved through the use of medication (e.g. reducing impulsiveness)

:*Where safety may be improved through the use of medication (e.g. reducing impulsiveness).

When considering whether to incorporate psychoactive drugs into a treatment program for problem behaviour, there are several conditions which should be met:

'''When considering whether to incorporate psychoactive drugs into a treatment program for problem behaviour, there are several conditions which should be met:'''

#A diagnosis, and ruling out of causative medical problems.  

#A diagnosis, and ruling out of other causative medical problems.  

#The clinician should have knowledge of the neurochemistry relating to the condition.

#The clinician should have knowledge of the neurochemistry relating to the condition.

#The clinician should have an awareness of the supposed mechanism of action of the selected drug.

#The clinician should have an awareness of the supposed mechanism of action of the selected drug.

These guidelines are important to ensure the correct use of drugs within the behavioural field, as administration of medication is always long-term in comparison to most other drug use and they help the owner take-part in the process of evaluation as to the effectiveness of the drug prescribed <ref>Overall, K.L., 2004. Paradigms for pharmacologic use as a treatment component in feline behavioral medicine. Journal of Feline Medicine and Surgery 6, 29-42.</ref>.

These guidelines are important to ensure the correct use of drugs within the behavioural field, as administration of medication is always long-term in comparison to most other drug use and they help the owner take-part in the process of evaluation as to the effectiveness of the drug prescribed <ref>Overall, K.L., 2004. Paradigms for pharmacologic use as a treatment component in feline behavioral medicine. Journal of Feline Medicine and Surgery 6, 29-42.</ref>.

==Combining behavioural therapy with medication==

 

==Combining Behavioural Therapy with Medication==

Depression, anxiety, fear and phobia may be associated with genuine long-term neurotransmitter and synaptic changes in the CNS, but these changes are reversible through new learning in combination with medication.

Depression, anxiety, fear and phobia may be associated with genuine long-term neurotransmitter and synaptic changes in the CNS, but these changes are reversible through new learning in combination with medication.

An example of a typical approach to fear using behavioural modification would be:

'''An example of a typical approach to fear using behavioural modification is:'''

*Identify all fear provoking stimuli

*Identify all fear provoking stimuli.

*Identify the threshold for the fear response (e.g. distance from target)

*Identify the threshold for the fear response (e.g. distance from target).

*Establish a gradient of stimuli (distance, appearance of person etc). This should be used to understand approach-avoidance behaviour.

*Establish a gradient of stimuli (distance, appearance of person etc). This should be used to understand approach-avoidance behaviour.

*Control the pet’s environment to reduce stress (prevent exposure in uncontrolled situations)

*Control the pet’s environment to reduce stress (prevent exposure in uncontrolled situations).

*Desensitisation and counter-conditioning: desensitise using gradually increasing exposure to fear-eliciting stimulus at a level below which fear is evoked, use counter-conditioning to replace fear with another incompatible emotional response to the same stimulus.  

*Desensitisation and counter-conditioning: desensitise using gradually increasing exposure to fear-eliciting stimulus at a level below which fear is evoked, use counter-conditioning to replace fear with another incompatible emotional response to the same stimulus.  

In such a case, medication that reduces the intensity of fear, and increases exploratory behaviour would facilitate desensitisation and counter-conditioning.

In such a case, medication that reduces the intensity of fear, and increases exploratory behaviour can facilitate desensitisation and counter-conditioning.

A similar approach is used for anxious behaviour:

'''A similar approach is used for anxious behaviour:'''

*Identify contexts and situations that elicit anxiety.

*Identify contexts and situations that elicit anxiety.

*Desensitise and counter-condition contexts and situations that elicit anxiety.

*Desensitise and counter-condition contexts and situations that elicit anxiety.

In such a case, an anxiolytic medication, such as an SSRI drug, can be used to facilitate desensitisation and counter-conditioning. This will reduce hyper vigilance and arousal so that the cat settles more quickly in the environment.

In such a case, an anxiolytic medication, such as an [[Selective Serotonine Reuptake Inhibitor Drugs|SSRI]] drug, can be used to facilitate desensitisation and counter-conditioning. This will reduce hyper vigilance and arousal so that the cat settles more quickly in the environment.

In the human behaviour field, psychoactive medication is extensively used in combination with cognitive and behavioural approaches to treat problems relating to fear, phobia and anxiety. In the veterinary behaviour field there are only a very few drugs which have been properly tested under controlled trials. For the majority of other medications there is minimal available data and information is extrapolated from use in the field of human psychiatry. When using drugs which are not licensed for veterinary use, it is important to consider that drug metabolism and effects vary between species. <ref name="Merck">Merck Veterinary Manual - [http://www.merckmanuals.com/vet/behavior.html Behaviour] (10th Edition) 2011 The Merck Publishing Group</ref>.

In the human behaviour field, psychoactive medication is extensively used in combination with cognitive and behavioural approaches to treat problems relating to fear, phobia and anxiety. In the veterinary behaviour field there are only a very few drugs which have been properly tested under controlled trials. For the majority of other medications there is minimal available data and information is extrapolated from use in the field of human psychiatry. When using drugs which are not licensed for veterinary use, it is important to consider that drug metabolism and effects vary between species. <ref name="Merck">Merck Veterinary Manual - [http://www.merckmanuals.com/vet/behavior.html Behaviour] (10th Edition) 2011 The Merck Publishing Group</ref>.

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[[Category:Pharmacological Approach to Problem Behaviour]]

[[Category:Pharmacological Approach to Problem Behaviour]]

[[Category:JBowen reviewed]]

[[Category:JBowen reviewed]]