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| − | ==Mechanism of Action==
| + | #redirect[[Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine)]] |
| − | Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) which functions by inhibiting the reuptake of serotonin in the pre-synaptic neuron.
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| − | Fluoxetine is largely metabolised in the liver by the cytochrome P450 enzyme system to norfluoxetine, also an SSRI.
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| − | ==Uses==
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| − | *Licensed (dog)
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| − | :*Treatment of canine separation anxiety<ref>Dodman, N.H., Shuster, L., 1994. Pharmacologic approaches to managing behaviour problems in small animals. Vet. Med. 89, 960-969.</ref><ref>Beaver, B.V., 1999. Canine Behavior: A Guide for Veterinarians. W.B. Saunders Company, Philadelphia, PA, pp. 26-28.</ref><ref>Overall, K.L., 2001. Pharmacological treatment in behavioral medicine: the importance of neurochemistry, molecular biology and mechanistic hypotheses. Vet. J. 162, 9-23.</ref><ref>Landsberg, G., Hunthausen, W., Ackerman, L., 2003. In: Handbook of Behavior Problems of the Dog and Cat, 2nd ed. Elsevier Saunders, Philadelphia, pp. 258-267.</ref><ref>Simpson, B.S., Papich, M.G., 2003. Pharmacologic management in veterinary behavioral medicine. Vet. Clin. North Am.: Small Anim. Pract. 33, 365-404.</ref><ref>Simpson, B.S., Landsberg, G.M., Reisner, I.R., Ciribassi, J.J., Horwitz, D., Houpt, K.A., Kroll, T.L., Luescher, A., Moffat, K.S., Douglass, G., Robertson-Plouch, C., Veenhuizen, M.F., Zimmerman, A., Clark, T.P., 2007. Effects of Reconcile (fluoxetine) chewable tablets plus behavior management for canine separation anxiety. Vet. Ther. 8, 18-31. Sonawalla, S.</ref> in conjunction with behaviour modification in dogs over 6 months old.
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| − | *Unlicensed
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| − | Fluoxetine is not recommended for treatment of aggression. | |
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| − | As with other drugs used to treat behavioural problems it is recommended that fluoxetine be used in conjunction with behavioural modification techniques <ref>Petit, S., Pageat, P., Chaurand, J.P., Heude, B., Beata, C., 1999. Efficacy of clomipramine in the treatment of separation anxiety in dogs: clinical trial. Rev. Med. Vet. 2, 133-140.</ref><ref>King, J.N., Simpson, B.S., Overall, K.L., Appleby, D., Pageat, P., Ross, C., Chaurand, J.P., Heath, S., Beata, C., Weiss, A.B., Muller, G., Paris, T., Bataille, B.G., Parker, J., Petit, S., Wren, J.,
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| − | 2000. Treatment of separation anxiety in dogs with clomipramine: results from a prospective, randomized, double-blind, placebo controlled, parallel-group, multicenter clinical trial. Appl. Anim. Behav. Sci. 67, 255-275.</ref><ref>Seksel, K., Lindeman, M.J., 2001. Use of clomipramine in treatment of obsessive-compulsive disorder, separation anxiety and noise phobia in dogs: a preliminary, clinical study. Aust. Vet. J. 79, 252-256.</ref>
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| − | Due to the long half-life of fluoxetine it is not necessary to gradually reduce or taper the dose. Once treatment with fluoxetine has ceased continued behavioural modification is advisable to avoid the reappearance of clinical signs. The long half-life of fluoxetine and its metabolites also mean that a period of at least 6 weeks should be allowed to pass before administration of any drugs which may interact adversely.
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| − | ==Adverse Effects==
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| − | *Decreased appetite
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| − | *Depression/lethargy
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| − | *Shaking/shivering/tremor
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| − | *Vomiting and diarrhoea
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| − | *Restlessness and anxiety
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| − | *Seizures
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| − | *Aggression
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| − | *Mydriasis
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| − | *Vocalisation
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| − | *Weight loss
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| − | *Panting
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| − | *Confusion
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| − | *Incoordination
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| − | *Hypersalivation
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| − | '''Caution should be taken in if the animal suffers from any of the following pre-existing medical conditions:'''
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| − | *Contraindicated for animals with a history of epilepsy or seizures
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| − | '''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
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| − | *Fluoxetine should not be given at the same time as drugs which lower seizure threshold eg. phenothiazines such as acepromazine or chlorpromazine.
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| − | *Monoamine oxidase inhibitors (MAOI), or within a period of 2 weeks after discontinuation of treatment with a MAOI.
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| − | *Fluoxetine has not been evaluated with drugs that affect the cytochrome P450 enzyme, care should therefore be taken with any drug that affects the enzyme system eg. ketoconazole.
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| − | ==References==
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| − | <references/>
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| − | {{unfinished}}
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| − | [[Category:To Do - Behaviour GGP]]
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