DOur sunny, selfless shadows, ogres want more than a daily walk, a snack or two, and human happiness. But in veterinary offices, dog parks, and internet forums, their own well-being is increasingly a focus of concern.
Veterinarians across the country have acknowledged an increase in the prescription of Prozac for dogs, as well as cheaper drugs marketed for humans to treat separation anxiety, social phobia, biting, and other problem behaviors in pets. There are also countless generic mood stabilizers.
Experts told STAT that this increase speaks volumes about the human mental health crisis in America and the ready availability of cheap generic drugs. Depression and anxiety have been reported to be on the rise in Americans in recent years, and it's something everyone is talking about more and more. But while behavioral specialists, therapists and counseling services are struggling to keep up with the onslaught, relatively inexpensive antidepressants are not keeping up.
“The human world has become more attuned to mental health. Since COVID-19, we've been talking about it,” says Melissa Bain, a veterinarian specializing in behavioral medicine at the University of California, Davis. Told. “When you start recognizing human things, you start recognizing dog things.”
I have to talk about buddy.
An apparent mental health crisis in pets occurs in the midst of a very obvious mental health crisis in humans. Rates of depression and anxiety among Americans hit record highs during the pandemic and continue to rise. Prescriptions for mood stabilizers such as Prozac and Zoloft have been steadily increasing since the 1990s, and they have skyrocketed during the coronavirus pandemic, sometimes causing drug shortages.
Meanwhile, licensed health care providers are struggling to meet psychotherapy and other behavioral health needs, and federal regulators are pushing to make these services more affordable.
“Mental health is like a sock.” [we] It's not a rubber band, it's a stretch,'' said Ken Duckworth, chief medical officer of the National Alliance on Mental Illness. “People are not returning to their pre-COVID baseline.”
At the same time, there are obvious bottlenecks in the service. The demand for psychological support and psychiatry far exceeds the number of frontline health care workers. Appointments can take weeks or months for many Americans, and it can take even longer to see improvements. Groups like the American Psychiatric Association tout the mental health benefits of owning a pet while touting the benefits of therapy animals and natural therapies.
Pet psychiatry mirrors human trends in several ways. Veterinarians across the country say they are writing more prescriptions for anti-anxiety drugs, but the increase in prescribing trends is difficult to quantify precisely. Veterinarians in five different states told STAT that prescribing popular mood stabilizers like Prozac to pets has steadily increased. However, pet prescription data is dispersed (usually by owner name), making it virtually impossible to fully understand trends nationally.
As in the human world, prescriptions, especially cheap generic anti-anxiety drugs, are often easier and more affordable than the hundreds to thousands of dollars it costs for training classes and professional behaviorist practices that are also recommended by veterinarians. price.
Generic versions of these drugs, especially the lower-dose versions that many of our smaller, furry friends are prescribed, typically sell for $10 to $15 per month. The pet-approved version of his Reconcile is a little more expensive. On the other hand, training courses and professional behaviorists can cost thousands of dollars. For many people, it's an easy choice.
A world of converging prescriptions
Dogs are basically taking the exact same depression and anxiety medications that humans are on. One of the most commonly used antidepressants in both human and animal fields is Prozac and its generic version, fluoxetine. His Reddit message board about reactive pets and veterinary questions has hundreds of posts about pet successes and struggles with them, Zoloft, Paxil, Celexa, and their generic versions.
Analysts expect the global market for these drugs to continue to grow from approximately $11.6 billion in 2019 to more than $18 billion by 2027.
They have been around for years and are easily accessible. In fact, little has changed in the world of psychiatry in the past 20 years. Once Prozac, Zoloft, and other selective serotonin reuptake inhibitors became generic drugs, few doctors recommended the name brands to their patients because of their effectiveness and low cost. Also, few large pharmaceutical companies were tempted to develop next-generation options.
When new drugs come on the market, they often have narrower approvals (such as Sage Therapeutics, a drug for postpartum depression) and higher prices. The same is true in the world of dog medicine, with only one FDA-approved fluoxetine option, Reconcile (specifically approved for separation anxiety).
Experts were quick to say that the demand for pets was not enough to worry about a shortage. There are currently no antidepressants on the national drug shortage list. Back in 2020, Zoloft and its generic version Sertraline faced problems securing enough of the active ingredient, which is typically manufactured in India or China, due to a surge in demand amid pandemic shutdowns, combined with supply chain disruptions. Pfizer, the maker of Zoloft, was able to ramp up production within months.
“There's definitely a shortage of basically every major SSRI, whether it's fluoxetine or paroxetine.” [Paxil], sertraline increases over time,” said Erin Fox, a pharmacist at the University of Utah who tracks the shortage issue. “It doesn't happen very often, but once it happens, it definitely seems to last for a while.”
These allow patients (human or canine) to transition to different doses or other drugs while manufacturing is on track. In one case, it took nearly two years for a single manufacturer to resolve the shortage of a little-used antidepressant called nefazodone.
“Part of the reason for that is simply because generics have become popular and so many different products have disappeared,” Fox said, referring to the diminishing appetite for producing cheaper generic drugs. Mentioned. But she also said there could be more shortages of all kinds of drugs in the coming years as the FDA ramps up factory inspections that have been delayed or interrupted by the pandemic, showing signs of trouble and then producing production. warned that there may be delays.
“This goes hand in hand with the increased demand for psychiatric services. However, some [media] With outlet [increased prescriptions] “They see it as a secondary issue, and they don't really understand it,” said Petros Levonis, president of the American Psychiatric Association, referring to the broader mental health crisis narrative. Ta. “I don't think you would ever say, 'People's high blood pressure is increasing, and high blood pressure drugs are also increasing.' It just goes hand in hand.”
Does this trend apply to us as well?
Veterinarians who spoke to STAT said the rise in pet psychiatry is due to a variety of factors. As a culture, we are placing more emphasis on animal welfare these days. There is also an ongoing pilgrimage of rural shelter animals being adopted from southern states and transported to cities with more capacity and resources for adoption, while far more There are also people, noise, and environmental stressors. Then, pandemic closures exacerbated this trend, with record adoption rates sometimes emptying entire shelters.
“It's not surprising that they have a hard time in urban environments, because they're not born into that environment,” said Kristin Calder of the American Veterinary Behavioral Society, a suburb of Portland, Maine. said Kristin Calder, owner of Calder Veterinary Behavioral Services in . “More and more people are taking the drug. It's also becoming more accepted.”
But human psychologists are increasingly studying how companion animals affect our health, and how we affect the health of companion animals.
Lori Kogan, a psychologist at Colorado State University and chair of the human-animal interaction section of the American Psychological Association, said the field has grown rapidly over the past 20 years.
“There are so many similarities between how people feel about their children and how they feel about their pets,” Kogan says. “For example, we may be overly concerned about our children's health, just as many people are concerned about their children.”
Those seeking to study how pet ownership has changed since the pandemic, and whether humans and their best friends are helping each other through stressors, from isolation and illness to unemployment and anxiety. There are some too. It is widely believed that pets are beneficial to people's mental health, but how does the opposite occur? our Their impact on health has until recently been largely unstudied.
The benefits for humans seem obvious. According to a March 2024 mental health poll conducted by the American Psychiatric Association in partnership with the American Veterinary Medical Association, 84% of pet owners believe that small housemates have a mostly positive impact on their mental health. The answer is yes.
In the UK, psychologists asked around 5,000 pet owners what they thought about their own mental health and the welfare of their cats and dogs following strict early closures. The results suggested that when owners themselves were depressed, they saw, or at least thought, their pets were improving.
“Those most in need of social support may be more empathetic towards the needs of animals, as evidenced by declines in mental health scores since lockdown,” UK researchers said. is writing.
Of course, they said, there are limits to this trend. Most of the survey respondents were women, and many of them were working outside the home before the closure. The study found that while not all pet owners have become more concerned about the health of their pets, certain groups, likely high-income individuals in office jobs who may transition to working from home, suggests that this is definitely the case.
Although the link between human and animal behavioral health is a relatively limited field of research compared to the study of human mental health, Kogan says it is rapidly growing and evolving.
“There's more and more focus on how to do this to mutual benefit,” she said. “When animal-assisted therapy started, there was a huge focus on what animals could do for humans. And now it's so much more than that. What can I do for you?”
