Psychotropic Agents for Integumentary Disease

Psychotropic drugs have been used extra-label for treatment of feline psychogenic alopecia and canine acral lick dermatitis, syndromes characterized by excessive self-licking (also see Abnormal Repetitive Behaviors and Feline Compulsive Disorders). Classes of drugs used include antidepressants, antipsychotics, opiate antagonists, anxiolytics, and mood stabilizers (see Table: Psychotropic Drugs Used for Skin Disorders).

Sedation is the most common adverse effect of diazepam. It is also an appetite stimulant in cats. Idiosyncratic fatal hepatic necrosis has been reported in several cats treated for as little as 8–14 days. Tricyclic antidepressants are potent H₁ blockers in addition to inhibiting uptake of serotonin and norepinephrine. These drugs can induce cardiac arrhythmias and lower the seizure threshold. Other adverse effects include dry mouth, hypersalivation, vomiting, constipation, urinary retention, ataxia, disorientation, depression, and anorexia. Tricyclic antidepressants should not be used concurrently with monoamine oxidase inhibitors, including amitraz dips for demodicosis. Dosages should be tapered slowly when discontinued.