Behaviour Modifying Drugs Flashcards
How may personality predisposition and life events lead to ultimate behaviour?
Combination of personality (genetic traits, developmental experiences) and life events interpretted in light of innate personality ->
“normal” well adapted with good emotional homeostasis
“abnormal” poorly adapted poor emotional homeostasis
Egs. of life events
- situation of emotional conflict or frustration
- experiences of threat or fear
- conditioned contextual associations with anxiety
How do arousal and emotional response interact to give rise to a behavioural outcome?
Additive to push arousal over a threshold where behavoiur ocours
- hence why behaviour may be elicited in some situations and not others (d/t initial underlying arousal state)
What are the 2 potential appliactions for drugs?
- anxiety reduction to v baseline levels of arousal
- fear reduction, impulse inhibition or memory suppression to avoid negative life events
When is drug therapy indicated?
- specidic drug indication eg. separation anxeity (LIC clomipramine)
- if emotion so intense that it is interfering with therapy (intense anxiety, fear or phobia, risk to people or property)
- animals sufering or distress could be alleviated
- prognosis improved or improvement speeded up
What are the 3 phases of drug therapy?
- initiation
- maintainance
- withdrawal
What can occour during the initiaion phase?
- adverse effects (may predispose/increase aggression)
- changes in emotionality (may make behaviour unpredictable, increase confidence or disinhibition)
- delay in onset of main effects can take 4-8 weeks
When is treated maintained until?
- end of period drug is licensed for
- period of normal behaviour
- indication that emotional component is less significant and behavioural modification alone will be successful
How should withdrawal be carried out?
- no information on data sheeets but unpleasant side effects welld ocumented in man
- discontinuationi syndrome with TCA/SRI/SSRI with short t1/2 eg. clomipramine (+ selegeline?)
- potential for recidivism if drug withdrawn suddenly
General time span for medication
- 6-8months
- until 6-8 weeks with no signs
- then decrease by 25% per week
- for 1 week per month of treatment
Hazards of using medication
- adverse effects
- therapeutic failure (~60-70% effective tx)
- disinhibition (benzos, TCA. SRI, SSRIs, acepromazine)
- excessive confidence and assertiveness (selegeline)
- owner ocerdependence, poor concurrent behavioural modification
What is selegeline lic for?
emotional disorders in dogs
3 classes of drugs?
> serotonergic
dopaminergic
GABA ergic
How to SRIs work?
> immediate effect
- prevent re-uptake of serotonin at the synapse
- ^ [serotonin] -> moe occupied receptors
- ^ serotonin may ^ anxiety
delayed effect (desired changes in animal behaviour)
- receptor downregulation
- maintainance of ^ [serotonin] with drug withdrawal
What causes most side effects of serotonergic (TCAs/SRIs/SSRIs) drugs
mixed antagonism also of other receptors
- Histamine H1 (weight gain, sedation)
- Acetyl choline M1 (constipation,d ry mouth, urinary retention)
- a adrenoceptor (hypotension and sedation)
- Noradrenaline reuptake inhibition
Eg of TCAs
Amitriptyline
Eg of SRIs
Clomipramine
Egs of SSRIs
Fluoxetine
Sertraline
Eg of SARIs? How should this be given??
Trazodone
- in combo with SSRIs
Eg of MAOb inhibitor
Selegeline
Eg of GABA-ergic drugs
Benodiazepines
Which drugs are serotonergic?
TCAs
SRIs
SSRIs
SARIs
Which drugs are dopaminergic
MAOb inhibitors
How selective is Amytriptaline for serotonin? What is it indicated for use in?
SRI:NRI 1:4 (more selective for noradrenaline, ^ no. side effects)
- anxiety and pain
- especially good for feline idiopathic cystitis
How selective is clomipramine for serotonin? What is it indicated for use in?
SRI:NRI 5:1 (quite serotonin selective, can ^ dose without side effects)
- anxiety and compulsion
How selective is fluoxetine for serotonin? What is it indicated for use in?
SRI:NRI 15:1 (very seletive!!!)
- anxiety, compulsion, impulsion, aggression
Egs of when serotonergic drugs are indicated for use
- compulsive circling (dogs) or kneading (cats d/t poor weaning)
- feline hyperaesthesia [clomipramine]
- impulse control (when mid-level behaviours are inhibited) [fluoxetine “prozac”]
- separation anxeity
How selective is sertraline for serotonin? What is it indicated for use in?
SRI:NRI 150:1 (VERY selective! But v range of useful situations for indication)
Specific uses of amitriptaline
- feline interstitial cystitis
Specific uses of clomipramine
- generalised anxiety
- separation anxeity
- compulsive disorders
- indoor spray marking (cats)
- felin hyperaesthesia syndrome
Specific uses of fluoxetine
- generalised anxiety
- separation anxeity
- compulsive disorders
- indoor spray marking (cats)
- felin hyperaesthesia syndrome
- impulsive aggression (eg. owner directed)
- frustration related aggression (cats)
Specific uses of sertraline
- generalise anxiety
- noise phobias
Common adverse effects of serotonergic drugs in man and in general
>man - headache - abdo pain - muscular rigidity > general - delirium - hyperthermia - insomnia - v seizure threshold - constipation - photophobia
Drug specific adverse effects of amitryptaline?
- irritability, agitation, tachydysrhythmia
Drug specific adverse effects of TCAs
- corneal drying
- TCAs that are strongly noradrenergic can -> explosive emotional reactions in man
What potential drug interactions can happen with serotonergic drugs?
- Amitraz (not used much UK)
- Opioids (resp depression)
- MAOIs (selegeline)
- phenothiazines
Specific medical cautions of serotonergic drugs?
- CV Dz (arrythmias)
- DIabetes (TCA/SRI drugs hyperglyceamic)
- thyroid dz alters metabolism of TCAs
- epilepsy
- narrow angle glaucoma
What is a SARI? Give specific eg.
serotonin receptor agonist and reuptake inhibitor
> Trazodone (Trazonil, Desyrel)
- published trial as adjunct tx including dogs with noise phobias
- NOT LIC
- use adjunct if dogs have not responded well to others
- risk of serotonin syndrome
What should selegeline (MAOI) not be combined with?
SRIs
How does selegeline work?
- selective MAO1b inhibitor
- has very low levle of MAO1a inhibition
- can be given WITHOUT DIETARY REQUIREMEMTS needed for MAO1a drugs
- other MAOIs cannot be substituted for selegeline
Main effects of selegeline?
- MILD v anxiety
- ^ conditionability even in normal animals
- ^ exploratory and risk taking behaviour
- v FEAR
- CARE! NEEDS CONCURRENT BEHAVIOURAL MOD OR CAN BE DANGEROUS
What are dopaminergic drugs choice for?
CCD and fear and phobias
Adverse effects of dopaminergic drugs
- agitation
- GI signs
- Drowsiness
- man headache,d rowsiness, abdo pain , hallucinations
Drug interactions of MAOIs
- TCA/SRI/SSRI
- Phenothiazines
- potentiates benzos (may be useful??)
- pethidine
How do benzos work?
- ^ Cl concentration in post synaptic membrane via GABA-A ligand gated ion channel
- stabilises membrane and v firing
- rapid onset
- affect memory
Main effects of benzos
- amnesia (anterograde and retrograde)
- anxiety reduction
- reduced panic
- ^ exploratory and risk taking behaviour
Adverse effects of benzos
- agitation (inc hyperexcitability esp greyhounds)
- ataxia
- sedation
- amnesia
- recidivism
- tolerance
- disinhibition of aggression
Are benzos indicated for long term use?
NO!!
- cannot do behaviour mod at same time as wont learn anything
