Siobhan's Confusion

The next email exchange I received said the following:

HI , I’m not sure what the mixes of meds will do to him. If he’s already on Pheno and Elavil? Does he need the other two. Should they be mixed?

Siobhan

And so I wrote to her the following response:

The other meds, prozac etc. would replace the Elavil. He can stay on the pheno as per my Vet...one doesn't affect the other. He takes one at night and one in the am so that only one is in his system at a time.

I'd like to get him the started immediately on the proper psych meds. They do work differently even though they are both psych.

Elavil is in a group of drugs called tricyclic antidepressants. The drugs recommended are: clomipramine (Clomicalm®) and fluoxetine (Prozac®) These are a different class of psych drugs from the tricyclic.
http://www.petplace.com/cats/feline-hyperesthesia/page1.aspx

This explains why he MUST stay on the pheno during this time.


"Drugs that help are potent serotonin-enhancing medications. In the brain, the neuromodulator, serotonin, stabilizes mood and has anti-obsessional and anti-aggressive effects. Drugs that have been found effective include clomipramine (Clomicalm®) and fluoxetine (Prozac®) though, theoretically, any potent serotonin-enhancing drug, including paroxetine (Paxil®), sertraline (Zoloft®), and fluvoxamine (Luvox®) should all work. These drugs take a while to become effective. Typically nothing much is seen for the first three weeks. Then, by four weeks, owners might notice a 50 percent reduction in the incidence and severity of bouts of FHS. Typically, the improvement may reach 75 percent at eight weeks, 85 percent at 12 weeks, and 95 percent by sixteen weeks. Complete cure is rare and most cats need to remain on medication long term to suppress the FHS behavior. This need not be a problem since the doses employed are small, therefore inexpensive, and medical complications of treatment are rare. Nevertheless, it makes sense to have treated cats checked by the veterinarian, including appropriate bloodwork, at least once per year."

During these last few email exchanges there were also phone calls. On each call I kept asking Siobhan to call my Vet or have her Vet call mine. That NEVER happened.