A variety of psychoactive agents has been used to treat behavioral disorders in birds; however, controlled studies of their use in these patients is lacking. Before treatment with psychoactive drugs is begun, the following must be in place: a complete physical examination, baseline laboratory testing, an established behavioral diagnosis based on complete behavioral and medical histories, a behavior modification plan with appropriate environmental modifications, knowledge of the drug (including side effects, indications, and mechanisms of action), a signed owner consent statement, and realistic expectations for treatment outcomes. As dose titration trials do not exist for birds, gradual dose increases in individual patients is recommended, starting with a low to moderate dose; then gradually increasing it until clinical effects, or side effects, are seen. Medications should be gradually tapered, or discontinued if possible, once the behavior problem has been stabilized for 1 to 2 months, as long-term effects of these drugs are not known. Anecdotal reports of sudden death with tricyclic antidepressants and antipsychotic drugs exist, and controlled clinical studies are needed to determine the safety and efficacy of psychoactive drugs in birds.

COMMENTARY: This article provides a useful overview of the use of psychoactive drugs for treatment of avian behavioral disorders. Also included are more detailed reviews of serotonin reuptake inhibitors, tricyclic antidepressants, opioid antagonists, benzodiazepines, hormonal therapies, and antipsychotic agents. Modes of action of each of these drug classes are discussed, as well as indications and potential side effects. Results of various case reports and the author's own clinical experience with some of these drugs help to make the article clinically useful, as do the dosage tables for some of the more commonly used psychoactive drugs. This article would be an excellent resource for any practitioner who sees birds in practice, even if it is only the occasional feather-picker.

Pharmacotherapy for behavioral disorders in pet birds. Seibert LM. J EXOTIC PET MED 16:30-37, 2007.