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October 29, 1955


Author Affiliations

Durham, N. C.

From the Department of Medicine, Duke University School of Medicine and the Cardiovascular Service, Duke Hospital.

JAMA. 1955;159(9):836-839. doi:10.1001/jama.1955.02960260006002

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.1 These compounds are considered to be free of serious toxic reactions.2 Mild 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.3 In some patients receiving Rauwolfia preparations in large doses, depression may develop.4 Although 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

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