Hematemesis and Melena Complicating Treatment with Rauwolfia Alkaloids

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Abstract
Alkaloids of Rauwolfia serpentina, especially reserpine, are being used widely in the treatment of hypertension and mental illness. In addition to their pharmacologic actions on the cardiovascular and central nervous systems, a variety of effects have been reported on the gastrointestinal system. Both gastric secretory and motor activity in dogs are augmented by reserpine.1 Increased volume and acidity of gastric secretions has also been found in man under the influence of reserpine.2,3 Hypermotility of the lower gastrointestinal tract is clinically evident in the occasional complaint of diarrhea in patients taking the drug. Emetic effects, suggesting hypermotility of the upper gastrointestinal tract, have been reported in animals and man.4 These actions on the gastrointestinal tract, produced in the main by the cholinergic-like action of the drug, suggest that duodenal ulcer might be activated. Such activation of ulcer in patients receiving reserpine has been reported.4 Hematemesis and melena

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