Depression and Anxiety Occurring During Rauwolfia Therapy

During recent years extracts of Rauwolfia serpentina have been utilized freely in the treatment of hypertensive vascular disease and varied psychiatric illnesses. Initial preparations for clinical investigation were provided only in crude form; but a highly purified alkaloid, reserpine, is now available. In general, the pharmacological properties of the crude and the purified derivatives are essentially the same.¹These compounds are considered to be free of serious toxic reactions.²Mild side-effects frequently encountered are nasal stuffiness, decreased initiative, fatigue, weight gain, drowsiness, nightmares, and diarrhea. These symptoms usually can be relieved by reducing the dosage of the drug without appreciably sacrificing its hypotensive effect.³In some patients receiving Rauwolfia preparations in large doses, depression may develop.⁴Although this complication occurs with significant frequency, it has received comparatively little emphasis in the literature. The purpose of this paper is to report the cases of 7 patients (of