Veterinary psychopharmacology

PUBLISHING YEAR: 2006

SUMMARY: Textbook of psychotropic pharmacological compounds and their use in clinical practice, as well as their pharmacokinetics, costs, adverse effects, etc.

AUDIENCE: GP vets who want to refine their pharmacological approach to pervasive behavioural complaints.

REVIEW 

Hold on to your horses there, as I am not going to hold back on jargon in this one.

The authors: Sharon Crowell-Davis is a veterinarian, board-certified veterinary behaviourist diplomate and animal behaviour researcher. Thomas Murray is a researcher and lecturer in (human) physiology and pharmacology.

Style and contents: Veterinary psychopharmacology is a textbook, so it’s as dry as it gets. Don’t be picking this up hoping for a relaxing week-end read. You will need a modicum of knowledge about pharmacology (basics of PD/PK, etc.) and neuropsychiatry to keep up.

The book takes you through the major neurotransmitters’ pathways and their role in psychological disorders. The book then introduces the major types of drugs that act upon these transmitters (e.g. SSRI, benzodiazepines, etc.) and their route of action, indications and contraindications.

Once the scene is set on the major classes, the book zooms into the relevant labels (e.g. fluoxetine, etc.). For each drug, the book covers adverse and paradoxical effects (both in research, and in the author’s clinical experience) among other things.

This book could be invaluable to the GP vet wanting to gain some insight into what specific compound is the best indication for a specific patient and condition. More importantly, it will also give you insight into what conditions/patients should not be administered a particular compound.

The book also did a good job at covering the societal and ethical concerns around dispensing psychopharmacological compounds to dogs, a topic I briefly tackled myself.

Possible improvements: My copy is getting a little old: a lot has happened since 2006. I can’t wait until a new edition comes out.

I would love to see more of the small case studies they added at the end of each chapter. These were well-summarized and gave a better feel for the clinical realities of psychopharma treatment in terms of dosage, duration, effectiveness, etc.

I would love to see a matrix overview of the major relations: linking things like compounds, complaint, costs, adverse effects per compound (and their incidence), clinical effectiveness, etc.

I would love to see an entire chapter devoted to diagnoses, with clear and (reasonably) mutually exclusive definitions and classifications. I am quietly chuckling to  myself as I type these words as I am aware I am only asking for the nosological holy grail of veterinary behaviour medicine, a project that many have attempted and failed at. But what little mention they made of diagnoses and their accompanying definition was excellent (succinct and unambiguous). So I would love to see them take a systematic stab at it.

It missed at least one paradoxical adverse effect that I know can turn up in clinical practice (i.e. the potential increase of predatory motivation under SSRI’s). Anecdotal as these findings are, you need to rely on case studies in a field where large scale double-blind placebo-controlled long-term effectiveness/toxicity studies are so few and far between. I would have also loved more beef on the discussions surrounding the risk of a paradoxical increase in aggression when the dog is on certain benzodiazepine compounds.

Some passages were excruciatingly unclear, switching the subject of a sentence to its opposite halfway through a sentence, for example.

The verdict: As far as I know, a more accessible book on veterinary psychopharma is not available for the dog behaviour professional – please leave a comment below if you know of one. So if you have even a tenuous grasp of receptor biology, pick this one up and familiarize yourself with this controversial subject. It will inform your opinion and you will become a better advocate to your client’s needs for the cases that require a little bit of additional help to get things changing. And of course, rush up and read this one if you’re a GP vet who wants to find out more about psychopharma.

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