10 Medications for Dog Anxiety

Dogs can experience different types of anxiety or behavioral disorders, some of which can be truly debilitating. As pet parents, we want to help, but we’re faced with many confusing treatment and medication options.

Your veterinarian is the first stop for the best resources for treating dog anxiety. Once your vet has given your dog a clean bill of health, they can start to make recommendations for your dog’s treatment. Treatment plans for anxiety often require the help of a veterinary behaviorist or a licensed dog trainer. As part of a behavior modification plan, your veterinarian may also recommend a medication for your dog's anxiety.

How Dog Anxiety Medications Work

No matter which medication your veterinarian chooses, you will also need to put behavior-modification protocols in place to help your dog work through their anxiety.

Because anxiety in dogs can present in such a wide variety of ways (such as fear, stress, impulsivity, obsessive behaviors, aggression, panic disorders, and noise phobias or aversions) there are medications available for both short-term and long-term use. Regardless of the type of medication your dog is prescribed, there are no quick fixes and working with a certified behaviorist or trainer is the best way to help resolve your pet’s abnormal behavior.

For conditions that require long-term medical treatment, dogs may need to be treated for four to six weeks before the effectiveness of the medication becomes fully evident, and treatment needs to continue for at least two months after a response is observed.

Long-Term vs. Short-Term Treatment

Some dogs can eventually be weaned off anti-anxiety medications, while others require long-term treatment. Dogs that are on medications for six months or longer should have yearly checkups and blood work done, as well as and periodic behavior reevaluations to ensure their current treatment plan is still the best option for their needs.

Some anxiety or stress triggers (such as car rides, trips to the veterinarian, or thunderstorms) may benefit from the use of short-term medications that take effect quickly and only last for a short period of time. These medications are often not designed to be used consistently.

Common Anxiety Medications for Dogs

A quick note: Fluoxetine and Sileo are FDA-approved for use in dogs. The other medications are all human medications, used off-label in dogs. The term off-label or extra-label use means that a medication can be used in a way or in a particular species that are not specified on the medication label. Off- or extra-label use of a medication can only be done by a veterinarian who has direct and personal knowledge of your dog and when there are no other appropriate medications for a particular dog's circumstances.

These medications are often given in tablets that are too large for dogs, so they may need to be compounded by a specialty pharmacy into a flavored chewable tablet, capsule, liquid, or transdermal medication.

Here are the most commonly prescribed dog anxiety medications.

1. Alprazolam (Xanax®)

Indications: phobias, fear, panic disorders

Alprazolam is often prescribed to help dogs who become anxious during thunderstorms, but it may also be used for other types of situational anxiety.

It’s a member of the benzodiazepine class of sedatives, which work by depressing activity in certain parts of the central nervous system (the exact mechanism of action hasn’t been identified). This is a short-acting medication that takes effect quickly and can be used up to four times a day. Alprazolam is most effective when given at the earliest sign of anxiety, ideally 30–60 minutes before your pup is exposed to the trigger. If this medication is ever used long-term, it should not be stopped suddenly.

Potential side effects include:

• Lethargy

• Sedation

• Incoordination

• Increased appetite

2. Amitriptyline

Indications: separation anxiety, reactivity, anxious aggression, or more generalized anxious tendencies

Amitriptyline is a tricyclic antidepressant medication that works, in part, by increasing the levels of the nervous system chemical messengers serotonin and norepinephrine, which affect mood. It should not be used with pets that have diabetes or epilepsy.

This medication takes one to four weeks to take effect and must be given twice daily. Amitriptyline is dispensed in the form of tablets that are given with or without food. Dogs should be gradually tapered off of amitriptyline if they have been on the medication for more than a week or two.

Potential side effects include:

• Constipation

• Lethargy

• Sedation

• Holding of urine

• Dilated pupils

3. Buspirone

Indications: phobias, social anxiety, mild generalized anxiety

Buspirone is a member of the azaperone class of anxiolytics. This medication requires continued use to be effective, so it’s not helpful for dogs that suffer from situational anxieties like thunderstorm phobias.

It appears to work as a mild anti-anxiety medication because it, in part, activates serotonin and dopamine receptors within the brain.

This medication takes up to six weeks to take effect and may need to be given two to three times a day. Buspirone is generally dispensed as tablets and given with or without food.

Potential side effects include:

• Loss of appetite

• Vomiting

• Sedation

4. Clomipramine (Clomicalm®)

Indications: separation anxiety, situational anxiety, compulsive disorders, irritability

Clomipramine is the first FDA-approved treatment for separation anxiety in dogs. It can also be prescribed for other types of anxiety.

It’s a tricyclic antidepressant medication that works, in part, by increasing the levels of the nervous system chemical messengers serotonin and norepinephrine, which affect mood.

This medication can take four to six weeks for a therapeutic effect to be seen, and up to two months is needed to determine whether it’s beneficial for a dog. Clomipramine should be given twice daily and should not be stopped abruptly.

Clomipramine is dispensed as tablets that are given with or without food. 

Potential side effects include:

• Lethargy

• Vomiting

• Diarrhea

• Agitation

• Sedation

• Increased heart rate

• Dry mouth

• Decreased appetite

5. Dexmedetomidine (Sileo®)

Indications: situational anxiety, noise phobias, aversions

Sileo® has been approved by the FDA to help dogs with noise aversion. It’s an alpha-2 adrenoceptor agonist that works, in part, by depressing activity in certain parts of the brain, which results in reduced anxiety levels, among other effects.

The drug works best when given 30–60 minutes before a triggering noise event or at the earliest sign that a dog is becoming anxious.

Sileo® is dispensed in a multidose tube as a transmucosal gel. The medication shouldn’t be swallowed—instead, it’s absorbed through the mucus membranes when applied between the cheek and gums. You will need to wear waterproof disposable gloves when handling the syringe and administering the medication.

Potential side effects include:

• Lethargy

• Vomiting

• Diarrhea

• Facial swelling

• Sedation

• Decreased heart rate

• Dry eye

6. Diazepam (Valium®)

Indications: situational anxiety, panic disorders, noise aversion, phobia

Whenever possible, diazepam should be given to dogs 30–60 minutes in advance of an event that’s known to cause anxiety. The drug can also be given at the earliest sign that a dog is becoming anxious, but it works best when given beforehand.

It’s a member of the benzodiazepine class of sedatives, which work by depressing activity in certain parts of the central nervous system. Diazepam is a short-acting medication that takes effect quickly and can be used up to four times a day. If this medication is ever used long-term, it should not be stopped suddenly.

Potential side effects include:

• Lethargy

• Sedation

• Incoordination

• Increased appetite

• Agitation

• Aggression

7. Fluoxetine (Reconcile® or Prozac®)

Indications: separation anxiety, aggression, compulsive behaviors, impulsivity

Fluoxetine is FDA-approved for the treatment of separation anxiety in dogs. It can also be prescribed for other types of anxiety and behavior issues, such as compulsive chewing, circling, self-mutilation (pulling fur out or licking skin compulsively), and even aggression.

Fluoxetine is a member of the selective serotonin-reuptake inhibitor (SSRI) class of medications. SSRIs prevent receptors in the brain from removing the nervous system chemical messenger serotonin, which allows for higher serotonin levels in the brain. Serotonin helps with mood regulation. Higher serotonin levels can help to reduce anxiety, impulsivity, and aggression.

Fluoxetine can take four to six weeks to take effect and should be given daily.

Potential side effects include:

• Constipation

• Loss of appetite

• Vomiting

• Diarrhea

• Agitation

• Sedation

• Lethargy

• Urine holding

8. Lorazepam (Ativan®)

Indications: situational anxiety, phobias, fear anxiety, panic disorders

Lorazepam is a short-acting medication that takes effect in about 30 minutes. Whenever possible, lorazepam should be given to dogs in advance of an event that is known to cause anxiety. The drug can also be given at the earliest sign that a dog is becoming anxious. This medication should not be stopped abruptly if you have been giving it long-term.

This medication is classified as a benzodiazepine and works by promoting gamma-aminobutyric acid (GABA) activity in the brain. GABA inhibits the effects of excitatory nerve signals in the brain, resulting in a calming effect on your pet.

Potential side effects include:

• Lethargy

• Sedation

• Incoordination

• Increased appetite

• Excitement

• Aggressive behavior

9. Paroxetine (Paxil®)

Indications: generalized anxiety, anxious aggression and anxiety-related behaviors, fear of noises, self-mutilation

Paroxetine is a member of the selective serotonin-reuptake inhibitor (SSRI) class of medications, which prevents receptors in the brain from removing the nervous system chemical messenger serotonin. This allows for higher serotonin levels in the brain.

Paroxetine can take four to six weeks to take effect and should be given once daily. Do not stop giving this medication abruptly if your dog has been on it long-term.  

Potential side effects include:

• Constipation

• Loss of appetite

• Drooling

• Vomiting

• Diarrhea

• Agitation

• Sedation

• Lethargy

• Urine holding

10. Sertraline (Zoloft®)

Indications: separation anxiety, anxiety disorders, impulsivity disorders, thunderstorm phobia, compulsive behaviors, fear-based aggression

Sertraline is a member of the selective serotonin-reuptake inhibitor (SSRI) class of medications. SSRIs prevent receptors in the brain from removing the nervous system chemical messenger serotonin, which allows for higher serotonin levels in the brain.

Serotonin helps with mood regulation. Higher serotonin levels can help to reduce anxiety, impulsivity, and aggression.

Sertraline, like other SSRIs can take four to six weeks to take full effect and should be given daily. It may be beneficial to taper dogs off of sertraline if they have been on the medication for two months or longer.

Potential side effects include:

• Lethargy

• Loss of appetite

• Vomiting

• Diarrhea

• Agitation

• Sedation

• Urine holding