Update on a horse on Prozac (fluoxetine)

I posted some time ago asking about this drug for a horse I bought in January. I talked with my vet and she in turn discussed my ADHD/spooky/reactive type horse with a DVM animal behaviorist. She thought it would be worth a try. I was to give him 60 mg/day the first week, increase by 60 mg/day each week until he was at a full dose of 240 mg/day (4 weeks to build him up to the full dose). BTW, I had already treated him for ulcers and had the vet check him for things like pain or poor eyesight. He checked out fine. Ulcer med didn’t change anything either. I used several calming supplements with no improvement.

He was up to 120 mg/day of fluoxetine and I could tell a difference. He was less distractable, better able to think when he got scared, more engaging with me–less “out there.” When I upped him to 180 mg/day, he started getting pushy and even a little semi-aggressive, behavior he had never shown before. I figured it was side effects, and I decided to wean him off it entirely.

After slowly weaning him, the pushy stuff went away, but the distractibility, spookiness, and ADHD stuff reared its ugly head again full force. He would also look through me and around me, rather than engage with me as most horses do. It was like he was so preoccupied with what was going on in his environment (waiting for the next bomb to drop) that he didn’t have any room to fit me into it.

I decided to put him back on the drug again, this time stop increasing the dose when he was at 120 mg/day, which had been a good dose for him before. Slowly the weird stuff improved. Don’t think he is perfect–he really is far from being a “normal” horse, but it sure is nice to have a horse that actually thinks better and isn’t as much of a space cadet as he was.

I plan to keep him on 120 mg/day for another month or so, and then I’ll VERY slowly increase it to see if I can get him up to the full dose and see what additional benefit he can get from it. My vet and I have discussed increasing 20 mg/day each week or two depending on his response to it.

He doesn’t act drugged at all. It’s just removed some of his anxiety. He used to get scared and freaked out about something and not be able to calm down. On the drug, he still gets scared or worried … but he seems to be able to come down from the fear more quickly, or never even get as worked up in the first place.

I have never given a horse an actual drug for anxiety. It’s been difficult for me to do. But this horse is really nice except for the anxiety. Unfortunately, I don’t know much about his past. I suspect he’s been passed around a lot in his short 7 years, and has a lot of mental/emotional scars from this. He’s a naturally sensitive horse. He needs stability. But, I also need stability and a safe horse. I want to give him a chance because he’s really a nice horse, and also because I don’t want to pass him on to someone else who may not be as tolerant of his issues as I am and then the cycle will continue, or he will end up at the slaughter house.

I don’t take giving him a drug lightly. It was a tough decision. And, I probably wouldn’t be doing it if I didn’t have a well-respected animal behaviorist vet guiding me through the process via my primary vet. But, the way I look at it is that it must be very hard for him to live with the level of anxiety he has, if the drug helps ease that while he gains some confidence and learns the world isn’t going to get him, it’s worth it.

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Is he under saddle while on Prozac?

My understanding of this type of drug is that dosage is tailored to the individual patient. That the recommended dosages are the starting point and adjustment is expected and part of the process.

In other words, 120mg appears to be working for your horse. 180mg appears to be too much. What additional benefit are you hoping to get from increasing the dose?

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Not so far. I’ve had some health problems of my own. I don’t expect him to be dull or unresponsive. He is the same in every way except more focused and somewhat calmer.

in humans with SSRI drugs, increasing too quickly can lead to side effects. I think that’s what happened with my horse as I was trying to get him up to a therapeutic dose–side effects, not because of too much of the drug in general. 120 mg is half dose. I just think increasing it so much only a week apart was too much for his body to handle. By increasing it more slowly, side effects may lessen. He has responded well to 120 mg, but he is still not where I think he can be. I think he can benefit more from the drug if I can increase the dose into the therapeutic range but more slowly to give his body more time to adjust to each increase. But if that tactic doesn’t work, I’ll try to work with where he’s at on a low dose.

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It’s super interesting to me that we have become super tolerant of humans having a lot of mental or anxiety issues that are innate to their personality or outside of their control. However when it comes to animals, or horses in particular, there is still a large resistance to medicating an anxious horse after pain/physical health has been ruled out. If human animals can be susceptible to mental illness, why can’t horses? It’s very common to see people simply state that it can be trained out of the horse or that it’s a problem with a lazy rider who doesn’t want to put “the work in.”

I found your story super interesting from that perspective on what has helped your horse. You are clearly trying to do what’s best for him and make his life more comfortable!

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A large part of the problem is that too many people want to use pharmaceuticals to replace training, or making alterations to management that they find inconvenient. Or, since it is not considered unethical in livestock–breeding for temperament as much as for looks.

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Just as an aside, I agree that the horse needs to be assessed for pain, then receive proper training and time before considering pharmaceuticals. Since that seems what happened with OP, i have no issue with now turning to alternative solutions to see if it helps anything.

Interesting that you bring up breeding because I think this happens in horses too. I’ve had two mares that ended up being unrideable. One because of chronic unsoundness and injuries and the other because of temperment. And before I get any grief for the temperment I tried for 3 years, managed to show the horse successfully and gave about 4 different trainers of varying philosophies a shot at turning her attitude around - no luck and I finally decided I didn’t want to deal with the risk of injury or death to myself anymore.

Everyone’s solution was, it’s a mare you should breed it. WHY ON EARTH would i breed two mares who have issues just because theyre mares. Cannot agree more with the whole breeding for temperment angle - if there were more responsible breeding programs perhaps we would be more successful/mitigate a lot of these mental issues in horses.

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I have been on Prozac before, and coming off of it was no walk in the park—I am not surprised at all by the behavior you described after you took him off of it. Have you ever heard of the brain zaps? I obviously have no idea how about the psychopharmacology of an SSRI in horses, but I am pretty convinced that if I were a horse and I started getting brain zaps, I would be pretty freaked out and distracted, too.

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Original poster here:

I have decided to wean him off the fluoxetine/Prozac. I may need to sell him this year, and no one wants to buy a horse that needs a drug. He was calmer and more focused on the drug, but he’s not that much worse as he is almost off the drug. He’s on 20 mg/day now (140 mg at the highest dose I had him on). Another few days on the 20 mg and then I will decrease it to 10 mg for a couple weeks, and then discontinue entirely. He hasn’t shown any problems coming off the drug. I’m watching him pretty carefully.

He seems better than before the drug. I think the drug helped take the edge off his anxiety. That and time have helped him become calmer overall. I believe it was the right decision for him.

I would not have put him on the drug unless my vet and the animal behaviorist at Cornell Vet School hadn’t supervised. They trusted me to know my horse and to use common sense with increasing/decreasing. I’m also a registered nurse and am familiar with the SSRIs. Giving drugs is a big deal and not something to enter into willy nilly.

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It sounds as though you are one of the people that uses behavior-modifying drugs appropriately.
It’s nice to hear that they appear to have been of some benefit (hopefully lasting).

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Reading with interest as I have a horse that has been prescribed Trazodone (by my vet) for ultra anxiety issues. I haven’t started the Traz yet because the weather here has been too awful to even think about starting consistent work with any of my horses. But once we start, if the Traz doesn’t help him then prozac was my vet’s next thing to try.

Good to hear that prozac has helped your horse. I too hope the benefits are long lasting.

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