Changes

====Drug Therapy====

====Drug Therapy====

Psychoactive medication is indicated in cases of "compulsive" over-grooming, or over-grooming that is leading to self-mutilation, or over-grooming with a strong underlying aspect of anxiety. Serotonergic medication such as the serotonin reuptake inhibitor (SRI) drug [[Selective Serotonine Reuptake Inhibitors (Clomipramine, Fluoxetine)|clomipramine]] or the selective serotonin reuptake inhibitor drug [[Selective Serotonine Reuptake Inhibitors (Clomipramine, Fluoxetine)|fluoxetine]] have anxiolytic and anti-compulsive effects. Fluoxetine can also improve impulse control in impulsive individuals. With clomipramine, cats may show adverse effects of lethargy and anorexia at higher doses, so treatment should start with a low dose, increasing it if there is no effect after 4-6 weeks. Clients should record the number and severity of self-grooming bouts seen during the 7-14 day period before treatment, as a baseline. The minimum treatment period is usually 6-8 months, with treatment being withdrawn once the cat's coat is fully restored and there has been a period of 6-8 weeks without signs of over-grooming or self mutilation. The withdrawal period should be 1 week per month of treatment, with withdrawal in three stages (75%, 50% and then 25% of therapeutic dose). Successful drug therapy should produce around 70% reduction in the behaviour and an increase in normal activity as a substitute. If there is a relapse, psychoactive drug treatment can be reinitiated. However, anecdotally, the response to successive courses of the same SRI or SSRI drug may diminish, so that it is sometimes better to treat relapses with a different psychoactive drug from the same class.

Psychoactive medication is indicated in cases of "compulsive" over-grooming, or over-grooming that is leading to self-mutilation, or over-grooming with a strong underlying aspect of anxiety. Serotonergic medication such as the serotonin reuptake inhibitor (SRI) drug [[Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine)|clomipramine]] or the selective serotonin reuptake inhibitor drug [[Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine)|fluoxetine]] have anxiolytic and anti-compulsive effects. Fluoxetine can also improve impulse control in impulsive individuals. With clomipramine, cats may show adverse effects of lethargy and anorexia at higher doses, so treatment should start with a low dose, increasing it if there is no effect after 4-6 weeks. Clients should record the number and severity of self-grooming bouts seen during the 7-14 day period before treatment, as a baseline. The minimum treatment period is usually 6-8 months, with treatment being withdrawn once the cat's coat is fully restored and there has been a period of 6-8 weeks without signs of over-grooming or self mutilation. The withdrawal period should be 1 week per month of treatment, with withdrawal in three stages (75%, 50% and then 25% of therapeutic dose). Successful drug therapy should produce around 70% reduction in the behaviour and an increase in normal activity as a substitute. If there is a relapse, psychoactive drug treatment can be reinitiated. However, anecdotally, the response to successive courses of the same SRI or SSRI drug may diminish, so that it is sometimes better to treat relapses with a different psychoactive drug from the same class.

====Summary of Treatment for Grooming Disorders====

====Summary of Treatment for Grooming Disorders====