I trained as much as possible, and used management strategies that I knew would help keep everyone’s stress levels down. If I wanted to train I had to take advantage of early mornings when my then 6 month old son was still sleeping. The holiday season was a turbulent time. I took a trip to visit my sister in New Orleans around Thanksgiving, we had friends and family visiting throughout the month of December and January and towards the end of January my husband went away on a business trip. I was feeling more than a little overwhelmed.
Raising a newborn on top of dealing with Frodo’s anxiety was taking its toll. I was seeing slow and steady progress with Frodo’s day to day training, and seeing some promising carry over into real world situations, but I did wonder if medication could compliment the training. The idea being that medication could alleviate his day to day stress levels and help accelerate training. On January 28th, Frodo’s 9th birthday, we were at the vet’s office to talk about medication. The vet gave us a prescription for fluoxetine, also known as Prozac.
Frodo on Medication
A day or two after Frodo was started on the medication my husband and I were surprised to see that Frodo was lying in the office, seemingly oblivious to the sound of a jackhammer down the street. This was noteworthy because Frodo is extremely anxious with sounds, especially with the sound of power tools. The construction continued for 3-4 weeks, and his behavior in relation to the noise of the construction evolved over this time, but I’ll get back to that later.
The Good, the Bad and the Ugly
The good: he was less reactive during the day. The bad: he became indifferent about eating his meals. And he became very difficult to engage in training. The ugly: he started to wake up screaming and scratching frantically at his face in the middle of the night. This happened every night, sometimes multiple times in the same night. So we went back to the vet.
The vet gave us a prescription of tramadol to be given each night before bed to help with any potential pain, although the exam did not reveal any clear reason for why he would be in any type of pain. Initially, the tramadol seemed to help a little, but after a few weeks the wake ups were back to the same level of intensity and frequency. At this point it was hard to tell if he was experiencing panic or pain. Maybe it was both? On some nights it was so intense that he involuntarily defecated. We went back to the vet.
The vet examined his teeth, and felt that he could benefit from a dental cleaning and potentially some extractions. We made some adjustments to the dosage of medication and we scheduled dental cleaning and extractions for the beginning of April. After the dental cleaning and extractions Frodo became a little more animated, which made me feel that his teeth had been bothering him, but the nighttime episodes persisted.
Training pre medication had been slow but steady, training post medication hit a plateau. It felt as though the medication had created murky waters. I thought back to when he was lying there with the sound of the jack hammer blasting away in the background.
Was he really as calm as he appeared with the noise of the jackhammer, or was there a disconnect between his internal response and his outward behavior? There is a wide held belief that medication helps by restoring a “chemical balance.” The reality is that there is very little research to support this. In fact, there’s more research to suggest that psychiatric drugs “work” by creating an “emotional flattening.” Here’s an article on the subject that’s worth reading: How do psychiatric drugs work?
I read extensively about these concepts during my time working in human mental health. Personal accounts from my clients supported this notion that medication was simply minimizing emotional responsiveness, not specifically targeting their anxiety, depression or other psychiatric disorders.
While Frodo’s reactivity was muted, and you might say that’s a good thing, it was nearly impossible to train with him if and when he did react. We made zero progress with the acquisition of concrete skills. He also began to develop anxiety associated with my office and our backyard. The most concerning part of it all was that my ability to connect and communicate with Frodo did not feel as strong as it had felt before. By mid-May I made the decision to take him off meds.
There may be some cases in which medication can help someone get through an especially traumatic period. It’s possible that “emotional flattening” can be helpful in some circumstances. But more and more I question the use of medication long term. I personally did not feel that there was any benefit to keeping Frodo on the fluoxetine, and I had little interest in experimenting with other medications. If anything I felt confident that I could make more progress with training once Frodo was off medication, and I was excited to get back to that path. As I weaned Frodo off the fluoxetine he began to exhibit some interesting behavioral changes. To learn more about how Frodo’s behavior changed after medication, be sure to stay tuned for Part 5.
Have you ever used medication to help a dog experiencing anxiety? What were your personal observations? Write in the comments below, I’d love to hear about your experiences.