My old roommate had a dog that had horrible separation anxiety, and also tried everything to help him, so I understand how hard it can be.
Have they tried some herbal remedies, such as Bach's Rescue Remedy? There are a lot of herbal medications that might be helpful to try before going to prescription drugs (but definitely do your research: some of these herbs are very potent and have their own side effects or can be harmful in high doses).
If that is not an option or doesn't help, and they have really tried EVERYTHING, and the vet felt comfortable in prescribing it, then it might be a good thing, even if there are some potential side effects in the future.
Think about it as a quality of life issue: if they continue to do nothing, this dog is going to suffer every single time they leave him alone, OR they can give him meds to relax him, making the separation less traumatic and making his overall life more pleasant, with a potential risk of causing side effects in the future-but certainly no guarantees that it will ever cause any problems.
I definitely am not a big medication proponent, but really if nothing else is helping this poor dog-why let him continue to suffer like that?
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