• Among 68 patients treated with Rauwolfia preparations, 20 developed some untoward side-effect. In three patients the prolonged administration of these preparations to relieve symptoms of hypertension resulted in the appearance of nasal congestion, excessive drowsiness, overeating, alarming nightmares, irrational behavior, and an incapacitating degree of agitated depression.
In all cases it was found possible to continue the use of Rauwolfia preparations by adding ephedrine. The recommended dosage is 8 mg. of ephedrine with 100 to 200 mg. of the whole powdered Rauwolfia root or with 0.1 to 0.25 mg. of reserpine, the combined dose being given three times daily. The ephedrine in this dosage did not interfere with the hypotensive action of the Rauwolfia and did relieve the above-mentioned side-effects.
Feinblatt TM, Feinblatt HM, Ferguson EA. RAUWOLFIA-EPHEDRINE AS A HYPOTENSIVE-TRANQUILIZER. JAMA. 1956;161(5):424–426. doi:10.1001/jama.1956.02970050026006