This is the second blog in a 3-part series about separation anxiety medications co-authored by Dr. Sophie Liu, Malena DeMartini, and Kathryn Gabriele.
When faced with big, important decisions, many of us (yes, we’re including ourselves here!) often begin with some Google “research.” We type in a few keywords, hit return, and hope our search yields the “right” information. If you’ve turned to Dr. Google to learn more about medications for treating separation anxiety in dogs, you are not alone. And, if you felt more confused and overwhelmed after reading the information returned, you are also not alone.
Our goal in this second blog in our three-part series is to empower you with the right information to guide you in making informed medication-related decisions with your veterinarian (or veterinary behaviorist). We mentioned this in the first blog in this three-part series, and it’s worth repeating again: not all dogs need medication to overcome separation anxiety, but for those who do, it should not be a last resort. You are your dog’s advocate, and we understand that means prioritizing their welfare.
Separation Anxiety Medication 101
That Google search likely returned a long list of potential medications to consider, and there are indeed several types of separation anxiety medication available. However, only two are approved by the Food and Drug Administration for treatment of canine separation anxiety alongside behavior modification: Reconcile1 (brand name for fluoxetine, more commonly known as Prozac) and Clomicalm2 (brand name for clomipramine). FDA approval is important because it indicates that the drug has been found to be safe and effective for treating this condition.
Both Reconcile and Clomicalm are maintenance medications, or medications that are administered daily for therapeutic effect. We mentioned both medications in the first blog, so let’s explore them in a bit more detail now:
- Reconcile is a flavored tablet of fluoxetine, a Serotonin-Specific Reuptake Inhibitor (SSRI), labeled for dosing once daily. SSRI medications can help dogs learn by changing the availability of serotonin in the brain, causing a wide range of anxiety-reducing effects. In one study looking at over 200 dogs diagnosed with separation anxiety, more than 70% of those treated with Reconcile and a behavior modification protocol improved.1 Thus, behavior modification is a necessary part of the treatment process. Like any medication there are potential side effects, and some of those reported from Reconcile are inappetence and lethargy.
- Clomicalm is a flavored tablet of clomipramine, a Tricyclic Antidepressant (TCA).2 Like SSRIs, TCAs affect the availability of serotonin in the brain, and they also affect other neurotransmitters, such as norepinephrine, that help regulate cognitive function and stress levels. Affecting other neurotransmitters can be beneficial for some dogs, improving their ability to learn while working a behavior modification protocol. Behavior modification must also be used in tandem with Clomicalm to successfully treat separation anxiety. Clomicalm can be given once or twice daily, and some of the side effects include inappetence and gastrointestinal upset.
A question we sometimes get about these two medications is about seizures being a potential side effect. For dogs with a pre-existing history of seizures, this is a good and important conversation to have with your primary. However, please know that for dogs without a pre-existing history of seizures this is an incredibly rare side effect of taking this medication. Additionally, recent literature has shown that SSRI medications may actually protect against seizures3.
Aside from these maintenance medications, there are several shorter-acting medications that may also help dogs with separation anxiety. Each one has a different mechanism of action, which is why many can be (and are) combined with each other or with maintenance medications to help treat separation anxiety. In general, short-acting medications reach peak effect a few hours after dosing and need to be timed several hours (usually 1-3) before a departure or stressful event. Short-acting medications also have potential side effects, which is why it’s important to discuss your dog’s individual situation with your vet, regardless of the type of medication being considered.
What Behavior Medication Can (and Can’t) Do
The goal of behavior medication as a complement to behavior modification is to enhance the dog’s ability to learn and retain. The medications we talked about in this blog are designed to give your dog a sense of calm and focus that allows for learning to happen more efficiently and effectively during the training process.
Successful behavior change relies not only on the ability to learn but also on positive learning experiences. While behavior medication can be a necessary component of enabling that learning to take place, it can not “do” the learning. For dogs struggling with separation anxiety, behavior medications can improve their ability to cope with stress and enhance their ability to learn. Behavior medications help the brain become more “plastic” or changeable, which allows it to be more open to taking in new experiences and building new associations. This, in turn, is what allows for the potential increased success and more desirable emotional and behavioral responses to working a behavior modification protocol.
We have to remember that both Reconcile and Clomicalm are FDA-approved drugs for treating separation anxiety alongside behavior modification. Behavior change of any kind, though, especially when dealing with emotional conditioning, takes time; there are no “silver bullets” or quick fixes to successfully treating separation anxiety. However, helping dogs to overcome it truly is possible! Careful, humane behavior modification is essential, and medications can help the behavior change process by increasing how quickly and how many dogs reach their alone-time goals.
Advocating for Your Dog
As always, we recommend you begin by speaking with your veterinarian (or veterinary behaviorist) about any medical decisions you make for your dog. Every dog is unique in their medical needs, and your veterinarian is a key partner in helping you find the right medication and dose for your dog to complement their separation anxiety training.
Each of us has different levels of comfort and experience with having those conversations, so we wanted to leave you with a couple of questions to consider asking your veterinarian. These questions can help you get information you need to feel confident about any medication decision-making:
- Here is a baseline video of my dog before we started separation anxiety training. Could s/he be a candidate for medication to support our behavior modification work?
- What are some pros and cons you’ve experienced with maintenance medications like Reconcile or Clomicalm, including potential side effects?
- What are some pros and cons you’ve experienced with short-acting medications for separation anxiety?
We recognize medication-related decisions are neither easy nor made lightly, and we hope it helps just a bit to know there are decades of science on your side and trainers who specialize in separation anxiety and veterinarians who specialize in behavior to support you – you are not alone!
Citations:
- Reconcile Fluoxetine Hydrochloride Chewable Tablets: Dogs. (2007). Freedom of Information Summary NADA 141-272. https://www.reconcile.com/wp-content/uploads/2020/08/Reconcile-FOI-Summary-2018.pdf
- Clomipramine Hydrochloride Tablets: Dogs. (2006). Freedom of Information Summary NADA 141-120. https://animaldrugsatfda.fda.gov/adafda/app/search/public/document/downloadFoi/646
- Sitges M, Aldana BI, Gómez CD, Nekrassov V. The antidepressant sertraline prevents the behavioral and EEG changes induced in two animal models of seizures. Epilepsy Behav. 2012 Dec;25(4):511-6. doi: 10.1016/j.yebeh.2012.09.005.
