Weaning Off Clomicalm

[Walliered]

Absolutely nothing helps with thunderstorm...not jackets or medicines. He is on 80mg. of Clomicalm now and I want to take him off of it. How? Thanks

[KF_in_Georgia]

How long has he been taking it? They say it takes a good two weeks for it to build up in his system, and I think you want to step down over about two weeks.

 

If he's taking it two times a day, then give him just one dose one day, both doses the next; one the next, both the day after. After those four days, step him down to one dose a day for four days; then one dose every other day until the current refill is gone...something like that. When I was getting Jacey off Clomicalm (after she'd been on for nearly three months), I gave her a morning dose on the days she was getting the single dose.

[Walliered]

He is taking one pill a day and it is 80mg. He has been taking it over 2 weeks and the thunderstorms really work on him. I have never seen anything like it and nothing I do will calm him. I have a bottle of Prozac and Valium that did not work either..I gave Jane a Thurder Jacket that did nothing..I have a Thuner Shirt that does nothing..I give up. But, do not want to take him off of the medicine all at once. Thanks

[macoduck]

I couldn't find any specific recommendations on how to reduce the dose, although this says to discontinue if there has been no improvement in behavior after 2 months:

a link to norvartis I guess your vet can give you the plan for reducing the dose, but you'd think Novartis would put it in their paperwork.

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some interesting reading here

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your dose looks correct:

 

Dosage And Administration

The recommended daily dose of CLOMICALM Tablets is 2 to 4 mg/kg/day (0.9-1.8 mg/lb/day) (see dosing table below). It can be administered as a single daily dose or divided twice daily based on patient response and/or tolerance of the side effects. It may be prudent to initiate treatment in divided doses to minimize side effects by permitting tolerance to side effects to develop or allowing the patient time to adapt if tolerance does not develop. To reduce the incidence of vomiting that may be experienced by some dogs, CLOMICALM Tablets may be given with a small amount of food.

 

Dog Weight (lbs)

 

CLOMICALM per Day

 

No. Tablets per Day

 

Tablet Strength

 

2.75-5.5

 

5 mg

 

1

 

5 mg

 

5.6-10.9

 

10 mg

 

2

 

5 mg

 

11-22

 

20 mg

 

1

 

20 mg

 

22.1-44

 

40 mg

 

1

 

40 mg

 

44.1-88

 

80 mg

 

1

 

80 mg

 

88.1-176

 

160 mg

 

2

 

80 mg

 

The specific methods of behavioral modification used in clinical trials involved desensitization and counterconditioning techniques. Since the manifestation of separation anxiety can vary according to the individual dog, it is advised that a specific behavior modification plan be developed based on a professional assessment of each individual case.

 

Once the desired clinical effect is achieved and the owners have successfully instituted the appropriate behavioral modification, the dose of CLOMICALM Tablets may be reduced to maintain the desired effect or discontinued. Withdrawal side effects were not reported in studies with CLOMICALM Tablets in dogs. However, in clinical practice, it is recommended to taper the individual patient dose while continuing to monitor the dog’s behavior and clinical status through the dose reduction or withdrawal period. Continued behavioral modification is recommended to prevent recurrence of the clinical signs.

 

The effectiveness and clinical safety of CLOMICALM Tablets for long-term use (i.e., for more than 12 weeks) has not been evaluated.

 

Professional judgement should be used in monitoring the patient’s clinical status, response to therapy and tolerance to side effects to determine the need to continue treatment with CLOMICALM Tablets and to continue to rule-out physiological disorders which may complicate the diagnosis and treatment of separation anxiety.

 

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some hard to read info about experiments here

 

 

[seeh2o]

2 weeks is not long enough for clomipramine to get up to a therapeutic level in the blood stream. Also, it isn't fast acting, nor is it a sedative. Your dog needs to be on it for a longer time in order to learn new coping skills in dealing with storms. The medication gives the dog a chance to do that, but the dog needs you to help with the training and learning. Carl was on it for 4-5 months for separation anxiety and it didn't "fix"it on its own or fix it quickly. It's as if the meds give them some space to reduce the anxiety so the dog can develop new skills in coping. I'd encourage you to stay with it longer, you won't see any change in 2 weeks.

[macoduck]

I missed the part about your boy only being on clomicalm for 2 weeks. I think it took Gracie at least 1.5 to 2 months before we noticed a change. IIRC she was only on it for a total of less than 4 months.

[Guest d0ggiem0mma]

I would not discontinue until he has been on it for 4-6 weeks. It takes a while to start working.

 

The dosage also seems wrong to me. My 35# whippet takes 40mg twice a day. The twice a day dosing works better (per a boarded behaviorist.) If your greyhound is taking the same dose as my dog, half his size, it must be a really low dose!!

 

Dosing these meds is not an exact science and often requires dose adjustments in the beginning. You also may need to use multiple drugs. Not to be rude, but it sounds like your expectations are a little unrealistic. We had to try several medications at different dosages before finding the right combo for my dogs. Maybe you should look into a more experienced behavior vet?

 

If you are determined to give up on the meds- I would talk to your vet about discontinuing them. They can give you the correct information to discontinue safely. DO NOT suddenly stop the drug or your dog WILL get sick.

[Walliered]

Thanks, everyone, I will keep my dog on it longer. I just hate to give meds to him and not see any change. But, maybe it will take several months. I wish we had a holistic vet in Savannah.

[Walliered]

One more question: If I do see positive results, should I keep him on it all year? We only have thunderstorms about 4-5 months a year. Thanks

[KF_in_Georgia]

Yes. It takes so long to build up in his system, and if you take it off you'll have to do it slowly, then wait months to let it build back up.

 

And if it becomes effective against thunder, it should be useful for fireworks, which covers the holiday season.

 

He'll need regular lab work while he's on the drug; ask your vet how often.

[Walliered]

Please tell me why he would need regular lab work. The vet did not mention it. I really think this is more of a reason to get off all drugs and go holistic. Only thing is, we live in a one horse town. Too bad Atlanta is 4 hours away.

[KF_in_Georgia]

Many drugs used over the long term can cause problems--liver damage is one thing. It's just a simple blood test recommended for dogs that are on Clomicalm for the long term.

 

Many dogs take Clomicalm all their lives and have no problems. They also have much less stress in their lives thanks to the drug. Stress causes physical problems, too.

 

Really, I'm not sure thunderphobia is something that can be dealt with holistically.

[JJNg]

Any medication has the potential for side effects, and with Clomicalm, the main reason to do bloodwork is to screen for elevated liver enzymes. I usually recommend checking bloodwork every 6-12 months with most long-term medications. Medication can affect the liver in a small number of cases, or if the dog develops unrelated liver problems, it can affect the processing of the medication. Just because meds have the potential to cause problems doesn't mean that they will - and in the vast majority of cases, they don't. I don't believe the small risk of side effects is reason to avoid a medication that your dogs needs and may allow him to have a better quality of life.

 

Dogs who are terrified of storms are truly having panic attacks. I don't think there's anything wrong with trying holistic options, if you can find something that works. Just keep in mind that natural or herbal don't necessarily mean safe or no side effects either. And if medication is the only thing that helps him cope with storms better, I believe it's worth the risk.

[greysmom]

Just as an added comment, NO drug is going to suddenly make him OK with thunderstorms or fireworks like nothing is happening. It just helps him cope a bit better. He may still shake, drool, whine, hide, or whatever his anxious behavior is, it just will (hopefully) be less stressful for him. Along with the drugs, you need to do some desensitization during the times when he's calm - there are lots of tapes/cd's that will walk you through this process, beginning with a few seconds of thunder barely audible and working up to him getting through a whole, real thunderstrorm.

 

I've had my girl Cash on xanax for three years (for spooky general anxiety) and THIS fourth of July was the first one she didn't spend shaking in the bedroom. We were even outside when a show suddenly started and she was fine. But it's taken THREE years! There really is no quick fix.

 

Many times, the best thing to do in this case, is nothing. Set him up in a safe room - an inner room of your house with no windows like a bathroom or closet - with a bed, and maybe a white noise machine or radio. Let him go there and hide out as long as he needs to.