Substances & Homeopatic Remedies

Rauwolfia serpentaria

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CONSTITUENTS
Indian snakeroot contains a complex mixture of indole alkaloids, including reserpine, rescinnamine, ajmaline, and yohimbine. Ajmaline has been used to regulate heartbeat.

toxicity:
• CNS side effects include drowsiness, severe depression, bradycardia, hypergastric secretion, nausea, nasal congestion, diarrhea and various sexual-endocrine dysfunctions (inhibition of menses, impotence).
(Duke JA. 1985, 401.)

• Epidemiological studies linking reserpine with breast cancer have not been supported by recent evidence.
(Hardman J, et al. eds. 1996, 791; Weiss RF, 157-158.)

• Although reserpine is considered relatively safe and of low toxicity in pharmaceutical terms, the use of Rauwolfia alkaloid containing herbs should be restricted to preparations of known alkaloid content by practitioners qualified in their use. Such preparations are not generally available in commerce.

contraindications:
• Depression: Insidious onset psychotic depression with possible suicide can result from long term reserpine use. Rauwolfia should not be used in patients with a history of depression.
• Pregnancy: due to alkaloid content.

Interactions

herbal constituent potentially affecting drug class toxicity: SSRI's
• research: Fujimiya et al. conducted research on the immunohistochemistry of rat brain in conjunction with a specific antibody against 5-hydroxytryptophan (5HTP) and found that 5-hydroxytryptamine (serotonin) was depleted by reserpine treatment. Their findings suggest that the targeted neurons synthesized more 5HTP by a process apparently stimulated by reserpine.
(Fujimiya M, et al. Histochemistry. 1994 Jan;101(1):21-26.)
• herbal concerns: Some physicians have used reserpine in conjunction with various antidepressants to reduce the side effects. These experiments have not yielded conclusive evidence or proven themselves in clinical practice. Findings from these animal studies may only be tangentially related to the situation of humans taking SSRI drugs along with reserpine-containing herbs. However, even such speculative indications suggest that individuals taking SSRI agents avoid taking substances containing reserpine, such as Rauwolfia, without consultation with and the supervision of their prescribing physician, preferably in coordination with a healthcare professional trained in medical herbalism.
(Schmauss M, Erfurth A. Fortschr Neurol Psychiatr 1996 Oct;64(10):390-402.)

herbal constituent potentially affecting drug class toxicity: Beta-adrenergic Blockers
• mechanism: Reserpine depletes central and peripheral caecholamines and may additively synergize with the symaptholytic actions of beta blockers.

herbal constituent potentially affecting drug class toxicity: Monoamine Oxidase Inhibitors
• mechanism: MAOI inhibitors elevate catecholamine levels; reserpine depletes central and peripheral catecholamines and may antagonize the effects of MAO inhibitor drugs, including Phenelzine.
• herbal concern: Despite lack of supporting evidence, prudence suggests that individuals taking MAOI's avoid taking substances containing reserpine, such as Rauwolfia, without consultation and supervision by their prescribing physician, preferably in coordination with a healthcare professional trained in medical herbalism.

Kardiologiia. 1976 Oct;16(10):76-80. Related Articles, Links  
[Changes in the hemodynamic indices of the pulmonary circulation and in the functional state of the right ventricular myocardium in stage II hypertension under certain types of hypotensive therapy]
Lazidi GKh.

The author observed 76 patients with Stage II essential hypertension undergoing combined therapy with Rauwolfia serpentaria, Isobarine and Hypothiazid, 37 patients treated with Dopegit, and 44--with Obsidan. The examined patients demonstrated pulmonary arterial hypertension or a tendency towards its development, an increasing lung-ear time interval, and a reduced functional capacity of the right ventricular myocardium. A direct correlation was established between the level of blood pressure in the general circulation and the pressure in the pulmonary artery and the degree of blood flow deceleration in the lung-ear interval. Combined therapy results in a reduction of the elevated blood pressure not only in the general, but also in the pulmonary circulation.