behaviour 8- The role of drugs, nutraceuticals and pheromones in behavioural medicine

Aims of altering neurochemistry

Promote Biogenic amines (catecholamines (dopamine, NA), serotonin)

Promote inh / hyperpolarising NT (GABA)

Methods of altering neurochemsitry

Medication, neutraceuticals, diet

When to use medication

Manage patients in vet visits - consultations, hospitalisation

Patients with physical health concerns influenced by emotional health

Patients with primary behavioural concerns with emotional component

Protocols for medication for vet visits

Aims - improve welfare, facilitate procedures, influence potential learning for future visits

Prep at home before visits, med on arrival, med during stay

Aim of pre vet visits med

Alter emotional bias, reduce emotional arousal, influence memory formation

Issue with inc doses for sedation

Inducing ataxia → perception of loss of control → inc protective emotional bias

Which behavioural cases will benefit from medication support

Emotional state inh learning -

High arousal

Protective emotions (fear anxiety, pain, panic grief, frustration)

Compulsive responses

Selection criteria for cases for drugs

Emotional + physical health diagnosis

Duration of problem

Severity of signs

Risk of euthanasia + rehoming → need quick results

Threat to welfare

Drug classes in behavioural medicine

Neuroleptics, azapirones, antidepressants (TCA, SARI, SSRI), monoamine oxidase inh, beta blockers, benzodiazepines, anti epileptics, opioid ant, CNS stimulants, antihistamines, hormonal preparations, adrenoreceptor stimulants/ ant, xanthine derivatives

Drugs for short term management - when to use

Situational emotional responses - fireworks, car travel, vet visits, visitors

Need rapid onset

Drugs for short term management - examples that influence NT levels

Serotonin - SARI (trazodone)

GABA - benzodiazepines (alprazolam, diazepam)

NA- alpha 2 ag (dexemedetomidine, tasipimidine)

Drugs for short term management - examples that inh neuronal signalling by binding to alpha 2-delta subunit of CNS voltage gated Ca channels

Gabapentin, pregabalin

Examples of drugs for long term emotional management - influence NT levels

Serotonin (TCA, SSRI, SARI)

Dopamine (MAOBI)

GABA

NA (clonidine)

Examples of drugs for long term emotional management - TCA features + examples

Clomipramine, amitryptiline, doxepin

Lag time to effect, don’t administer with MAOBI

Serotonin + NA action

Examples of drugs for long term emotional management - SSRI features + examples

Fluoxetine, sertraline

Lag time to effect, don’t administer with MAOBI

Examples of drugs for long term emotional management - SARI features + examples

Trazodone

Quick effect, for situational anxiety, can use with SSRI, dont use with MAOBI

Examples of drugs for long term emotional management - MAOBI features + examples

Selegiline hydrochloride

Affects dopamine, serotonin, NA

Neuroprotective action towards free radicals + neurotoxic substances

Don’t administer with pethidine, morphine, fluoxetine, phenothiazines

Anti epileptics - when to use

Limbic epilepsy, anxiolytic properties (neuroleptics), compulsive disorders (with SSRI)

Which medication to use in compulsive mutilation disorders (affects Na channels, GABA + glutamate receptors)

Topiramate

Hormone preparation examples + when to use

Female - cabergoline (dec prolactin + effects → dec anxiety + resource defence)

M - deslorelin (chemical castration)

Examples to use in situational anxiety

Benzodiazepines (alprazolam, loprazolam, diazepam)

Dexmedetomidine

Tasipimidine

Gabapentin

Pregabalin

SARI (trazodone)

Examples to use in generalised anxiety

TCA (amitryptiline, clomipramine, doxepin)

SSRI (fluoxetine)

SARI (trazodone)

Antiepileptics (pexion, topiramate)

Examples to use in compulsive disorders

SSRI - fluoxetine

Examples to use in panic disorders with anxiety

SSRI (sertraline, fluoxetine)

Examples to use in fear (poor behavioural development, stimuli, phobias)

MAOBI (selegiline)

Imepitoin

Examples to use in panic grief related behaviour change

MAOBI (selegiline)

Examples to use in cognitive dysfunction

MAOBI (selegiline)

Xanthine derivative (propentofylline)

Multimodal analgesia options in chronic pain

NSAIDS (meloxicam, firocoxib, robenacoxib, grapiprant)

Gabapentin, pregabalin

Paracetamol

NMDA ant (memantine, amantidine)

How to manage chronic pain (trials)

4-8w meds

Monitor response with CSOM / scoring systems

How to support cognitive function

Alter oxidative balance (antioxidants, essential fatty acids, phosphotidylserine)

Neutraceuticals

Diet

Support brain function

Medication (dopamine, superoxide dismutase, cerebral blood flow, glial cell modulation)

What NT are affected by nutrients

Serotonin, dopamine, GABA

Pheromone examples for dogs + cats

D- dog appeasing pheromone (adaptil calm/junior/transport)

C- feliway classic/ friends/ optimum

Issues with pheromones

Interaction with other chemicals, not in same room as birds