Stopping fluoxetine - any experiences?

[u/Longjumping_County65]

My dog-reactive collie has been on fluoxetine for just over a year and have made great progress with her reactivity and general behaviour so am wondering about weaning her off Fluoxetine/prozac. I'd love to hear people's experiences both positive and negative of tapering off Fluoxetine after it being successful for a period of time.

I so often see people describing it as a med for life but I think we put in a lot of hard work and the fluoxetine helped her be in a good place to learn. I just have a voice in the back of my head that thinks she might just have a bit more drive without it as the fluoxetine just overall dampened her responses - not that everyone wants more drive but I want her to feel joy and I feel like her food drive and enthusiasm for engaging is a little less now. And I want that drive to work and engage with me and I think it will help overall with our training to have that. I think there is a chance she regresses but I would happily put her back on the fluoxetine in that case. We've worked hard on bringing down her arousal levels and I also think there's a chance tapering off it increases her arousal back up out and about.

[u/MaleficentBake9995]

Former vet tech here and I just want to warn you about the potential convo you're in for with your vet:

There are a certain set of questions some vet will ask prior to approving your request to back off meds. This isn't them refusing to lower or taper off, just ensuring that you're making an informed decision. But it can throw clients off and make them feel like they're being pressured to maintain sedation even if that's not the goal of the attending DVM. So before you head in, ask yourself the following questions and be honest with yourself about the answers

(some of these are questions you've answered in your post already, but I still want to add them in for as much authenticity as I can give from my experience in these kinds of visits. Your vet might not ask any or all of these questions, I'm just adding as many as I can recall)

1) What is the exact reason you want to taper off meds? Is it because your dog is doing super well and you think you don't need them anymore? If that's the answer, could it be that a good amount of your dog's progress is linked to the medication and decreasing it might reverse some of that?

2) If your dog declines after the taper and settling period (the whole process is about 2 months before we know where your dog's baseline is sans meds) are you willing to return to medication or are there other treatment options you want to explore instead?

3) Pulling a dog off and putting them back on meds again can be really tough on the body, if you need to go back on meds are you comfortable with staying on them long term? Or are you hoping to just do a little more work and take her back off again? Are you aware that this might incur greater costs as the team may want to monitor her metabolic levels a bit more closely to ensure no ill effects?

4) Would you consider instead a taper down to a lower dose first (depending on the current dose she's on of course)?

5) What goals are you hoping to meet without medications? Be specific, this way you can see if your plans are realistic and also if you are meeting your expectations after the taper.

6) What would you look for to indicate that your dog needs to go back on meds again? What signs or symptoms do you think you would see? Are you sure these are signs that your dog is uncomfortable and not just that she is making you uncomfortable (example - "she pants and paces a lot and it annoys me" vs "she chews her paws bloody and destroys the couch" ) not that both of these scenarios can't indicate an anxiety issue, but one might be better treated with incidental sedation rather than long term SSRIs

That's all I can think of at the moment and again I don't want this to discourage you at all, if you think pulling her off fluoxetine is the right call then you should feel empowered to pursue it. I just know that some vets are really good at having in depth conversations about starting and stopping anxiety meds and I think having an idea beforehand of exactly what you want and what you're hoping to achieve with this will set you up well to defend your decision if you need it

[u/Lumpy_Physics3101 → u/MaleficentBake9995]

The same vet (techs) and behaviorists who say stuff like "going on and off meds is really hard on the dog" will also say things like "you might need to trial a bunch of different meds to find the right one." I'm not saying either is wrong, but those statements are contradictory.

[u/MaleficentBake9995 → u/Lumpy_Physics3101]

Not really, it’s the same in human medicine. You don’t want to be constantly switching around, it can really fuck with your mood and hormones, but sometimes it takes a few tries to find the right med 🤷‍♀️. I’m personally on antidepressants and it took 3 tries to find the right ones, doesn’t mean that skipping around didn’t do a number on my mental health and doesn’t mean I should jump off them and jump back on later

[u/Lumpy_Physics3101 → u/MaleficentBake9995]

You're not listening to the patient though, who is miserable on these drugs. If my vet put me through a whole gauntlet when I told them I was stopping fluoxetine, I'd tell them to pound sand.

[u/MaleficentBake9995 → u/Lumpy_Physics3101]

You are not my patient, your dog is. And I am listening to them - and advocating for them. If you tell me they are miserable, I’m gonna ask what makes you think that so I can better understand the situation. If you tell me “they’re perfect now so I wanna stop the meds that seem to have made them perfect” I am going to assume you’ve fallen prey to the recency bias.

My job is to ensure patients’ welfare and this needs to be a loooooooooooooooooooong discussion, how else would I know how best to move forward with treatment? You (presumably) did not go to vet school or nursing school but know your dog. I did go to school but don’t know your dog. We have to work together, I can’t do that without a conversation. Like I said, no one is trying to discourage you from making the choice you wanna make, we’re just trying to make sure you’re making an informed choice

[u/Lumpy_Physics3101 → u/MaleficentBake9995]

wait are you a vet?

[u/MaleficentBake9995 → u/Lumpy_Physics3101]

A vet tech. I went to three years of nursing school to do this job

[u/Lumpy_Physics3101 → u/MaleficentBake9995]

wait aren't you a nurse after nursing school? i'm so confused

[u/MaleficentBake9995 → u/Lumpy_Physics3101]

A veterinary nurse is not referred to as such in the states. We’re called vet techs. I went to veterinary nursing school - same basic schooling as human nurses with some added training specific to animals of all species. I have an associates in veterinary nursing. My license is for a veterinary technician 

[u/Lumpy_Physics3101 → u/MaleficentBake9995]

good work! TIL

[u/Longjumping_County65 → u/MaleficentBake9995]

Thanks! All super useful information. I've already spoken to my vet about this and she's happy for me to try it, as is my trainer. I already have pretty extreme tracking/monitoring in place and will continue to measure stuff during the taper and if signs are going in the wrong direction continuously, then put her back on.

[u/doggambit]

I took my Aussie off of it at one point after he’d been on it a few years. He went back to being an anxious barky mess. He went back on it a few months later, but at a much lower dose. He’s been great ever since, and he’s now 13.5 years old. 

[u/crash_cove]

I am fully in the meds for life camp with my pup but I will say that we had a lot of convos with our VB and one of the unacceptable side effects I listed was my pup not being her joyful, silly, energetic self.

I would try dose-reducing the Prozac first to see if that helps before tapering off since your pup has seen progress. If that doesn’t help, and your pup gets worse off the Prozac, I’d encourage you to ask about trying something else. Zoloft is super common and lots of pups tolerate that better (but YMMV). Good luck!

[u/nipplecancer]

I'm not taking my dog off altogether, but I recently reduced his dose from 20mg to 16mg, and it's been great. His appetite is back and he's more playful and communicative. It's only been a couple of weeks, but I'm glad I tried it. I haven't noticed any negative effects yet. Very briefly, he seemed more sensitive to noise, but now he's back to baseline.

[u/Longjumping_County65 → u/nipplecancer]

Useful! Thank you!

[u/Lumpy_Physics3101]

My experience was coming off of fluoxetine increased my dog's motivation for both food (was very minimal on it) and toys (she wouldn't play at all on fluoxetine). Dog was on it for around 6 months.

I had the same reasons for wanting to get off of it -- I was doing more training and found the motivation to really be limiting our progress (and making training less fun for me). Overall I'm glad to have done it.

Also if you don't like the dog off drugs, you can always go back on. It's not a life or death decision.

[u/emilla56]

I had my dog on that for about a year with no effect so I weaned him off it. He was only reactive on walks, he was fine in the house with family so we just managed by not walking as much and playing more in the yard. He had several doggie pals that would come over too.

[u/alandlost]

I took my boy off it earlier this year; we had started back in Dec 2022, so he was on it about 3 years.

I took him off partly because he's older now, so I figured he might do better than he had when he was young, but mostly because his sound sensitivity had grown more severe right after he started it. (I didn't realize back then that there could be a link given that my vet behaviorist didn't flag it as a side effect...)

He's harder to manage, barks more, gets way more amped up. Some of this is kind of sweet, since it's fun to see him at full excitement at an age when I thought he was slowing down, but some of it is definitely anxiety too, and it's kind of a pain in the ass for me tbh lol. But he's not jumping out of his skin at every bump in the night, and not having as severe panic attacks during storms/fireworks, so I'm happy with him off it.

If it weren't for the noise sensitivity, I'd have tried a lower dose rather than a full taper off.

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[u/tigervegan4610]

We did pull our dog off fluoxetine, but he had a lot of compounding health issues (congestive heart failure and lack of appetite on all those meds, pulled off Prozac to try and increase his appetite which worked). I didn’t notice much behavioral difference at that point, but also he was in heart failure so maybe that’s why he didn’t start reacting a lot again 🤷‍♀️. 

[u/Longjumping_County65 → u/tigervegan4610]

Sorry to hear that! That sounds tough!

[u/areweOKnow]

I took my dog off after 3yrs after consulting the VB. She was being sedated too much, not eating well and got very sound sensitive. She is also on gabapentin which we felt was making the better difference.

She has been much better off and most of the sound sensitivity has gone. She is a bit more amped up but her training is holding up so far and we are happy with the decision to come off it.