Trazadone increase anxiety/ aggression?

[algernon22]

Hello. We are in complete frustration. Our 2 y/o Chessie, whom we’ve had 16 months, is on fluoxetine. About 3 weeks ago, we added 1/4 tab trazodone in the afternoon. Her behavior has been very difficult lately. Has anyone had experience with trazodone increasing anxiety, reactiveness, and/or aggression?

We are stopping it tonight. We are at our wits end (I don’t have enough energy to post all the things).

 

[imagebeastmarkbeast]

@algernon22 Trazodone and fluoxetine are both serotonin drugs. Same thing happened to our dog. Vet told us that mixing the two is not optimal due to increased risk of serotonin syndrome. "Very agitated" is how I would describe my dog the two times he took both drugs on the same day.

How high is your dose of fluoxetine? We were at a low-moderate dose (32 mg for a 75 lbs dog) and just upped him to 40 mg, split in two doses (so 20 mg in the morning, another 20 mg late afternoon). Our dog had "adjusted" to the previous dosage, and while it was still working, not as well. This seems to have done the trick, at least for now. He's had a fantastic week!

If you need something in addition to the fluoxetine, our vet suggested other drugs that don't work on the same neurotransmitters. There are options, so talk to your vet.

 

[algernon22]

@imagebeastmarkbeast Thank you! Our pup alternates 40mg to 2O mg every other day for an average of 30 mg. She is about 55 lbs.

Fluoxetine is in the morning only. We started 25mg in late afternoon.

She is super edgy, seems more reactive, and things that used to be easier for her (going into her crate) are quite challenging.

That being said, her daily routines have shifted and she was recently boarded (at a place she loves and goes to day care regularly.)

We are really tired. She’s made some great improvements over the year but definitely are in a set back phase.

We have an appointment with the vet, but not until next week. Had a quick phone call and we stopped the trazodone tonight. Hoping that helps. Thanks for your input, it is much appreciated.

 

[jessica777777]

@imagebeastmarkbeast Could you please share what other options are available as an add-on to fluoxetine? I’d like to do some further research.

 

[theinformant]

@algernon22 Yes. Trazodone makes our 3 year old reactive Pom/Yorkie/shihtzu mix much more anxious/guarded. He’s on fluoxetine as well.

We have a “happy visit” at the vet’s on Wednesday afternoon, so I’m going to dose him as directed on Tuesday night, then two hours before the visit so the vet tech who we’ve been working with sees the difference between with traz and without traz. (We also have used gabapentin as an adjunct - that didn’t seem to work either).

 

[algernon22]

@theinformant Thank you! We stopped the traz today and have a vet appointment next week. Did you see any increased aggression or separation anxiety with your pooch on traz?

 

[theinformant]

@algernon22 Increased aggression for sure.
Hoping Wednesday will prove it for vet

 

[algernon22]

@theinformant Would love to hear how Wednesday goes for you if you have a chance to reply after!

 

[elizabeda777]

@algernon22 We saw the opposite. Fluoxetine increased aggro behaviors and traz did the opposite.

 

[algernon22]

@elizabeda777 Interesting, thanks. Is your dog still on traz and what’s the dose?

She started on trazodone a year ago. We switched to fluoxetine in the fall. We saw improvements, but there seems to be regression. Sometimes it’s hard to see all the good. Definitely will be having more conversations with the vet to see next steps. My gut wants to ween off of fluoxetine a bit and discuss other alternatives. I want to believe she can be better able to manage. We’ve been working our tails off with training and counter conditioning too.

 

[elizabeda777]

@algernon22 He’s been on traz for over a month now and doing great! Leash reactivity massively improved.

We tried fluoxetine twice and never made it past 2 days. It was bad. My understanding is that there is a loading period for this sort of stuff and side effects are expected. But I personally see most negative side effects as not worth it if we are looking at 1-2 months of them. But that’s my personal cost-benefit.

 

[jonbanjo]

@algernon22 Yes, trazodone definitely made my dog who was already on fluoxetine much more reactive. She already barked alot and the trazodone made that a lot worse. I've had good luck pairing her fluoxetine with clonidine, a non-psychiatric med but it has been very calming for my dog.

 

[algernon22]

@jonbanjo Thanks, that’s good info. My vet hasn’t mentioned that as an option but we haven’t had a med discussion for awhile. How much clonidine does your pup take?

 

[emilyhall]

@algernon22 Ha I already posted my response separately but came here to vote for Clonidine as well. For our dog, we can give her between 1-4 tablets (we've only gone as high as 3 so far) depending on the stress of the situation we'll be walking into. Right now, we give her 2 daily for the general activity of a morning walk at a quiet park where we can't always avoid every single trigger.

 

[emilyhall]

@algernon22 Ask your vet about Clonidine. Trazodone never really worked for our dog (also on Fluoxetine) and clonidine absolutely does.