Production of Premature Ventricular Contractions by Rauwolfia

Alkaloids of Rauwolfia serpentina (Ophioxylon serpentinum) are currently enjoying great popularity for treatment of a wide variety of disorders, ranging from insanity to various forms of hypertension. While this drug has been in use for many years in India, a large pharmacological literature is not available. Allen and co-workers, in discussing its use in hypertension, state that it "inhibits sympathetic system and reduces blood pressure by direct action on hypothalamus. Apparent parasympathomimetic action. Produces tranquility without somnolence." Toxic symptoms are said to include nasal congestion and stuffiness, mild bradycardia, sedation, muscular aching and stiffness, laxation, and at times nightmares and mental depression. Paresthesias, twitching of the limbs, chattering of the teeth, and pruritus have also been reported. We wish to report an additional and possibly significant toxic effect—ventricular premature contractions. We have been unable to find any report suggesting cardiotoxic effects. In August, 1953, one of us (B. N. W.)