Exotic Animal Formulary5

increasing complexity, and training of basic skills.
▪ Behavioral pharmacotherapy can be a useful component of treatment.
▪ Whenever possible, consult with a behaviorist, preferably a member of the American College of Veterin
Behaviorists.
4. Behavioral pharmacotherapy, general principles:
▪ These drugs may help the bird be more open to change, thereby reducing stress and increasing the cha
of success.
○ Most behavioral drugs act by exerting effects on neurotransmitters (NT) in the central nervous sy
(CNS).
○ Serotonin (5-HT) affects mood, sleep patterns, and appetite; also plays a role in the suppression of
impulses; low levels or an imbalance between serotonin and other hormones may be associated wi
maladaptive behaviors.
○ Norepinephrine (NE) plays an important role in attentiveness, sleeping, dreaming, and learning.
○ Gamma-aminobutyric acid (GABA) is a major inhibitory NT.
▪ Behavioral drugs are classified based on their first clinical use in humans or on their structure and effec
(tricyclics, selective serotonin reuptake inhibitors); major groups include anxiolytics, antipsychotics, an
antidepressants, but their use may be more generalized outside of these broad areas.
▪ A number of factors must be considered when selecting a psychotropic agent: the proposed mechanism
action, indications and contraindications, common side effects and the potential for other adverse effect
drug cost, and ease of administration; also consider the bird species, its age and underlying health, as w
as reproductive status; see information that follows or consult a veterinary behavior text or a general
formulary for more detailed information.
▪ Drugs commonly selected for:
○ Conditions of fear, phobia, or anxiety include benzodiazepines and buspirone; antidepressants may a
be used for generalized anxiety and separation anxiety.
○ Obsessive-compulsive disorders such as stereotypical behaviors a include TCAs and SSRIs.
○ Stereotypy that involves self-injurious behavior include opioid antagonists (i.e., naltrexone), SSRI
TCAs, and, in select cases, haloperidol.
○ Antipruritic effects include the TCAs; doxepin, followed by amitriptyline, have the most potent
antihistaminic activity. b
○ Aggression, both hierarchical and anxiety-induced, are the SSRIs.
▪ Ancillary treatments may include opioid analgesics (Table 5-5), NSAIDs (Table 5-6), hormonal agents (
5-7), and/or essential fatty acid supplements when indicated.
5. How much to give, how often, and for how long?
▪ Many of the doses in Table 5-10 are based on anecdotal experience or case reports; the few empirical stu
referenced use small sample sizes.
▪ Warn your client that, in many instances, dosing may be by trial and error; for instance, after giving a
antidepressant for 4-8 weeks, it may be necessary to adjust the dose, or in some instances to change dru
▪ Combination therapy can sometimes enhance drug effectiveness:
○ Benzodiazepines (BZDs) may be combined with antidepressants, but reduce the BZD dose to minim
the risk of CNS depression; this combination may be particularly helpful when psychotherapy is fi
started because it takes weeks for antidepressants to exert an effect.
○ Unless both dosages are decreased, avoid combining drugs that both increase serotonin levels sinc
there is the risk of causing serotonin syndrome. c
▪ Administer antidepressants for a minimum of 6-8 weeks.
▪ Monitor blood work regularly.
▪ When and if a beneficial result is achieved, it may be prudent to continue treatment for at least 2-6 mon
▪ The process of weaning a bird off of medication may also require trial and error; one technique is to red
475