Reserpine
Mechanism :
Reduces blood pressure via depletion of sympathetic biogenic amines (norepinephrine and dopamine); also, commonly results in sedative effects.
Indication :
- Agitated psychotic states (Schizophrenia)
- Hypertension
Contraindications :
Hypersensitivity to reserpine or any component of the formulation; active peptic ulcer disease, ulcerative colitis; history of mental depression (especially with suicidal tendencies); patients receiving electroconvulsive therapy.
Dosing :
Hypertension:
0.02 mg/kg/day PO in 1-2 doses, not to exceed 0.25 mg/day.
Adverse Effect :
Bradycardia, cardiac arrhythmia, chest pain, flushing, hypotension, peripheral edema, Anxiety (paradoxical), decreased mental acuity, depression, dizziness, drowsiness, drug-induced Parkinson’s disease, anorexia, diarrhea, hyperacidity, nausea, sialorrhea, vomiting, Immune thrombocytopenia, purpura, Blurred vision, optic atrophy.
Interaction :
Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect.
Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents.
Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect.
Opioid Analgesics: CNS Depressants may enhance the CNS depressant effect of Opioid Analgesics.
Tetrabenazine: Reserpine may enhance the adverse/toxic effect of Tetrabenazine.
Hepatic Dose :
Dose adjustment may be needed in the setting of hepatic impairment as the drug has extensive hepatic metabolism and plasma levels may be increased. Initiate dose at lower end of dosing range, use caution and titrate as per response.