Treating Behavior Problems in Cats (cont.)
Medicines for Treating Ongoing Behavior Problems
Behavior problems that involve day-to-day household issues, such as problems between multiple cats within a household, or ongoing problems, such as excessive grooming, are best treated with medicines that are given long term, such as TCAs, MAOIs and SSRIs.
Tricyclic antidepressants (TCAs) were first used to treat depression in people. They work primarily by increasing serotonin and norepinephrin-two neurotransmitters that are involved in regulation of emotional activity. They also affect other neurochemicals involved in emotional reactivity. The TCAs prescribed most for cats are amitriptyline (Elavil® or Tryptanol), clomipramine (Anafranil® or Clomicalm®), doxepin (Aponal®), imipramine (Antideprin or Deprenil), desipramine (Norpramin® or Pertofrane) and nortriptyline (Sensoval). Every cat is unique behaviorally and physiologically, so while one TCA might not work well for your cat, another TCA could have excellent results.
Although TCAs were originally intended to treat depression in people, they can also reduce anxiety, manage compulsive behavior and help people with anger problems. They've been used successfully in cats to help treat compulsive behavior problems like excessive grooming, reduce reactivity to other cats in the household and treat anxiety problems.
TCAs are prescribed for use every day. If the medicine isn't taken every day, it won't work to treat the behavior problem. TCAs are not usually effective the first day-or even the first few days-that they're taken. Because at least some of their effectiveness comes from the changes they make to the brain, TCAs must be taken for at least two to three weeks before they produce results. Treatment should continue for at least two months before a decision is made regarding the success of the drug.
TCAs are metabolized in the liver and excreted through the kidneys of a cat, so if your veterinarian advises you to treat your cat's behavior problem with a TCA, he should give your cat a simple blood test to make sure these organs are working well before beginning treatment. If your cat has had problems with her kidneys or liver, be sure to let your veterinarian know. It's recommended that a recheck blood test be done every year (twice a year for older cats) to ensure that the medicine hasn't damaged the liver or kidneys.
TCAs should not be used with MAOIs because the combination of these two types of drugs can increase serotonin to unhealthy levels.
TCAs can increase water retention, and water retention produces dry mouth. As a result, some cats might foam at the mouth, and they might also be extra thirsty. Because they're thirsty, they might drink extra water. Water retention can also lead to constipation and even diarrhea. All of these effects can lead to house-soiling problems. TCAs can also cause a sudden increase in heart rate.