Reserpine

Reserpine is an alkaloid, derived from the roots of Rauwolfia serpentine and vomitoria, and an adrenergic uptake inhibitor with antihypertensive effects. In the past, doctors have considered Rauwolfia to treat a wide variety of conditions (to note, the translation of one of its common ancient names is “Madman’s medicine”). It was only in the 1930s that attention was raised when its antihypertensive and antipsychotic actions were again identified and then later when reserpine was isolated in the 1952.

Its mechanism of action is based upon an inhibition of alpha-adrenergic transmission. Indeed, the natural alkaloid agent can inhibit the uptake of dopamine, norepinephrine and serotonin into presynaptic vesicles leading to a catecholamine and serotonin destruction that cause a depletion of their stores in central and peripheral nerve terminals. At the end all of this is translated into a lack of active transmission discharge from nerve ending upon nerve.

Despite widescale use for many years, reserpine has not been shown to cause clinically apparent liver injury.