Serpasil - Reserpine

When we began using reserpine at the Maudsley Hospital less than two years ago there were very few reliable accounts of its use in the treatment of neuropsychiatric conditions and almost no controlled clinical studies. Dr D. L. Davies and I therefore conducted a clinical trial on a mixed group of out-patients, the majority of whom were suffering from anxiety and depressive reactions. The patients were given either reserpine, prescribed as Serpasil in a dose of 0.5 mg. by mouth twice daily, or a seemingly identical placebo, for a period of six weeks. The two substances... 

Reserpine is used for treating hypertension however, it is not the drug of choice because of a number of side effects. A number of drugs combined with other hypertensive agents— diuretics in particular—are based on reserpine. Reserpine is prescribed under a number of names, including serpasil, brinerdin, diupres, and others. 

Reserpine is prescribed under a nnmber of synonyms, inclnding serpasil, brinerdin, diupres, and others. 

Reserpine (Serpasil) is the prototypical drug interfering with norepinephrine storage. Reserpine lowers blood pressure by reducing norepinephrine concentrations in the noradrenergic nerves in such a way that less norepinephrine is released during neuron activation. Reserpine does not interfere with the release process per se as does guanethidine. 

An example of this is the antihypertensive drug reserpine (Serpalan, Serpasil), which impairs the ability of adrenergic terminals to sequester and store norepinephrine in presynaptic vesicles. 

Reserpine (Serpasil) depletes the store of catecholamine peripherally and centrally and attenuates, but does not abolish, sympathetic reflexes. Reserpine is useful in the management of mild to moderate hypertension. Its onset of action is very slow (2 to 3 weeks) when given orally. The side effects of reserpine are manifested by cholinergic hyperactivity such as diarrhea, bradycardia, and nasal stuffiness. Reserpine can activate a peptic ulcer (cholinergic dominance) and cause depression (depletes norepinephrine stores). Reserpine and propranolol have potential cardiac depressant activity and should not be used together. 

Various neuroleptics are also used for nonpsychiatric purposes, usually in smaller doses for shorter durations. However, severe effects can sometimes develop from these limited uses. Reserpine (Serpasil) is a neuroleptic that is more often used to suppress the symptoms of tardive dyskinesia (chapter 4). Prochlorperazine (Compazine) is used as an antiemetic and rarely as a neuroleptic. If given in sufficient doses to manifest psychoactive effects, these drugs produce the same emotional indifference as the other antipsychotic drugs. 

Adrenergic Neuron Blockers (peripherally acting sympatholytics) Guanethidine monosulfate (Ismelin), reserpine (Serpasil)... 

Reserpine (e.g., Serpasil) Partially depletes catecholamine stores in peripheral nervous system and perhaps in the CNS. Decreases total peripheral resistance, heart rate, and cardiac output. Seldom used for mild to moderate hypertension. No longer recommended for psychiatric disorders. "Parasympathetic predominence" (bradycardia, diarrhea, bronchoconstriction, increased secretions), decreased cardiac contractility and output, postural hypotension (depletes norepinephrine inhibiting vasoconstriction), peptic ulcers, sedation and suicidal depression, impaired ejaculation, gynecomastia. Low risk of rebound hypertension because of long duration of action. 

Synonyms 11,17a Dimethoxy-186-[(3,4,5-trimethoxybenzoyl)oxy]-3g,20a-yohimban-16g-carboxylic acid methyl ester Trade names Diupres, Reserpine, Ropres, Serpasil, Unipres... 

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