Drug Interactions

Hello vets, My 13 year old dog was recently diagnosed with dementia and has not been sleeping. My vet prescribed him Gabapentin to be given before bed and Selegiline little over a week ago. We did not see any improvement. We went back to the vet on Monday and were prescribed more Gabapentin to be given along with the Trazadone as needed. My dog is still not sleeping through the night and if anything he seems more disoriented, scared and confused. I am very concerned as it seems to be doing the opposite of what I was told it would do. Can another vet please weigh in on whether these drugs are safe to be taken together? Thank you in advance!

Hello - I'm afriad that there is a code of practise strongly forbidding me (bearing in mind that I haevn't even met the patient or seen the clinical notes), from 'weighing in' on other vets' cases!   However, it's understandably very common that we encounter owners who are concerned about their vets' choice of drugs.  It is always the correct thing to do to raise this concern, because your vet will be working on the assumption that you are giving the drugs as prescribed; if you are worried about the drug choice, then there is a good chance that at best, you feel extremely conflicted about giving the meds and at worst, the patient might not get some help that they strongly need.   More to follow.

It sounds as though your dog is receiving the following drugs:  Gabapentin, Selegiline and now Trazadone.  Gabapentin and Trazadone are frequently used together, particularly in the states, to treat anxiety.  Selegiline is used for signs of cognitive dysfunction in dogs and cats and, according to Cornell University, can take several weeks to start working if it is going to.  However, from what you've said, your dog appears to be increasingly anxious.   Good questions to raise this with your vet include  1) What possible things could be happening in my dogs brain to cause the signs?   2) Is this definitely a diagnosis or are there some differential (alternative) diagnoses we need to consider? - also, would an MRI scan provide any more useful information?  3) How long should we give it to know whether these meds are working?  4) If there is no improvement, what then?   5) Is there anything we can do in the meantime to make life easier for my dog?   6) What is the evidence like supporting the use of these drugs?    This conversation would probably be a good place to start.

Gabapentin is sometimes prescribed for pain management, while Selegiline is used to treat cognitive dysfunction syndrome (CDS), a condition similar to dementia in dogs. Trazodone is often prescribed as an anti-anxiety medication, and it can sometimes cause drowsiness. It's not uncommon for medications to have side effects, and their interactions can vary from one individual to another, both in humans and in dogs. What might work well for one dog may not work the same way for another. It's possible that the combination of these medications is not suiting your dog and might be causing increased disorientation and confusion. Your best course of action would be to speak with your veterinarian as soon as possible. They can help evaluate the situation, adjust the medications, or explore alternative treatments that may be better suited to your dog's specific needs. They will be able to provide the most accurate advice and guidance for your dog's condition.

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