Somewhere along the line, I have lost touch, or track, or contact with reality. When I wasn’t looking, or perhaps working too hard with Woody Schwitzer on the revision of our soon-to-be-released textbook, Diagnosis and Treatment Planning Skills for Mental Health Professionals, A Popular Culture Casebook Approach, or revising my graduate courses in Abnormal Psychology, or studying the long awaited (and for some, long-overdue) recently released revision of the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5), or familiarizing myself with the Practice Parameters of the American Academy of Child and Adolescent Psychiatry or the Society of Clinical Child and Adolescent Psychology's Best Practices….I failed to realize that in 2007, the FDA approved Fluoxetine Hydrochloride (formerly Prozac, and now available as Reconcile by Eli Lilly, or in generic form through Pliva, a Croatian pharmaceutical manufacturer) for Canine Separation Disorder, or CSD.
Apparently, I was too caught up in wondering how to guide parents in my practice through the Scylla and Charybdis of psychosocial and psychotropic interventions, as well as contemplating how best to teach future clinicians how to intelligently and intuitively appreciate the nuances of psychiatric disorders in youth, to realize that my own dog, our own Sweet Princess was afflicted with a pervasive, insidious, highly distressing psychiatric disorder. So, when my wife called to ask if I could swing by the local CVS to pick up our dog’s prescription for Prozac, everything was dropped, including my jaw.
I might sound a bit facetious, but truth be told, I have long been fascinated with the social discourse around mental disorders and psychotropic drugs, since the publication of my book Psychotropic Drugs and Popular Culture: Essays on Medicine, Mental Health and the Media. I even sent a copy to Thomas Szasz who commended me on the effort. And more recently, I have become fascinated by the controversy surrounding the release of the DSM-V, spearheaded by psychiatrist Allen Frances, who chaired the task force that brought us the DSM-IV-TR. He was most unkind in his recent volume Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Parma, and the Medicalization of Ordinary Life, vociferously concerned that the American Psychiatric Association had medicalized most aspects of everyday life, and had inflated the ranks of psychiatric disorders, particularly those afflicting children. With the repositioning of many psychiatric disorders affecting kids (ADHD, Autism Spectrum Disorders, Learning Disorders) as “Neurodevelopmental Disorders”, Frances rightfully worries that the floodgates to further medicalizing and medicating our children will swing wide open. See where I’m going here?!
Getting back to the matter at hand; there I stood at the pharmacy counter waiting for my dog’s prescription. The guy next to me was picking up Seroquel, a powerful psychotropic for a wide range of 'serious' psychiatric disorders, while the woman ahead of me was quarreling that her anti-retroviral was indeed available in generic form. “Please put my prescription in a plain brown bag and don’t ask me out loud if I have any questions for the pharmacist about my dog’s Prozac”, I silently begged.
And lest you think that I don’t take seriously our dog’s suffering, or the suffering of all dogs for that matter; or that I am a pet-unfriendly curmudgeon who fails to appreciate the importance of our canine companions and the role they have played throughout the history of our species, or that I would for one second deny our beloved four-legged family member her right to a comfortable life when for sixteen lousy bucks, I can relieve her angst and unhappiness….you would be wrong. I was simply and powerfully struck in that moment by the idea of Prozac for pets, given the culture war that has been raging around overmedicating our human population. Thankfully, the FDA warns us that medication alone may be inadequate for effectively treating canine anxiety, and should be combined with behavior modification. I am not sure; however, if this black box warning flows from the results multi-site RCT (randomized controlled trials) research. The FDA wouldn’t want to think that pet owners would simply medicate their dogs without considering psychosocial factors.
No lessons to be learned here, thought I, from the war that has been fought to balance psychological, psychosocial, and parent-effectiveness training for parents who might otherwise and simply medicate their children.
Clearly, I am on the side of those who fear for the overmedicalization and the overmedication of our most vulnerable wards.
I will end by inviting you on a thought trip to Hollywood’s chic Center for Canine Happiness and Contentment (CCHC), whose past clients have included the likes of Lassie, who was treated for Canine Dependent Personality Disorder (CDPP), Stephen King’s Cujo who suffered from Reactive Attachment Disorder of Puppyhood with Antisocial Features (RADP-AS), and Old Yeller, who suffered from a Neurocognitive Dog Disorder with Depression ( NCDD-D); and whose current clients include Marley-Oppositional Defiant Doggie Disorder (ODDD), Scooby-Doo-Attention Deficit Hyperactive Disorder, Doggie Type with Generalized Anxiety Disorder (ADHDD-GAD).
I hope not to be sued for violation of confidentiality here. And the next time you are watching Alex Trebek, pay close attention to the commercials between Jeopardy, Double Jeopardy and final Jeopardy, where you are likely to see advertisements for Restless Paw Syndrome (RPS), Puppy Penile Deficiency Disorder (PPDD) and Doggie Dementia (DD).