GASTRIC SECRETION AS INFLUENCED BY RAUWOLFIA ALKALOIDS

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Abstract
The various Rauwolfia alkaloids were studied in reference to their effects on gastric secretion. Intravenously, 1 mg of reserpine evokes a significant and prolonged hyperchlorhydria. This response is not blocked by atropine, methantheline bromide, epinephrlne or vagotomy. Oral doses of the various Rauwolfia alkaloids induced hypersecretion when given in large (2.5 mg) single doses. Small or average single doses of those compounds did not influence gastric secretion. When Rauwolfia serpentina (200 mg/day) or reserpine (1 mg/day) was given over 14-day periods to normal volunteers, no significant alterations in gastric secretion or urine uropepsin excretion were noted as compared to a placebo effect in these same subjects. Rauwolfia serpentina and phenobarbital had greater value therapeutically in patients with duodenal ulcer or functional gastrointestinal disease than did an inert placebo administered to the same subjects. It is felt that the alkaloids of Rauwolfia exert their stimulating action on the stomach through local rather than central activity. This activity may be mediated by serotonin. Although no proof of their being ulcerogenic exists, it would seem wise to use large doses of the Rauwolfia alkaloids with caution, especially in patients with peptic ulcer disease. The real value of these agents, insofar as the gastrointestinal tract is concerned, seems to rest in their usefulness as a means of studying gastric secretory mechanisms.