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Journal of Psychopharmacology (Oxford,... Mar 2023Reserpine is an effective antihypertensive drug, but its role in routine practice has declined such that it is rarely used. This is largely based on the assumption that... (Review)
Review
BACKGROUND
Reserpine is an effective antihypertensive drug, but its role in routine practice has declined such that it is rarely used. This is largely based on the assumption that reserpine causes depression. This assumption was a foundation for the original monoamine hypothesis of depression. However, there remains conflicting evidence as to whether reserpine causes depression, and no systematic review of available evidence.
AIMS
We systematically reviewed evidence on effects of reserpine on depressive and related symptoms (e.g. anxiety, suicidal ideation).
METHOD
Electronic searches of MEDLINE, Embase and PsycINFO were conducted to identify studies up to 14 February 2021. Studies of any methodological design involving reserpine-treated and reserpine-untreated conditions, in any adult human population, were included and a narrative synthesis of findings was undertaken. Risk of bias (RoB) was examined using ROBINS-I.
RESULTS
Of the 35 studies meeting inclusion criteria, 9 were randomised controlled trials. Eleven studies reported some depressogenic effects, 13 reported no effect and 11 reported putative antidepressant effects. Studies identifying depressive effects were more likely to examine people without psychiatric disorders at baseline, while studies identifying a potential antidepressant effect tended to treat fewer participants for shorter durations, at higher doses. Around one-third of studies conducted in people with psychiatric disorders showed beneficial effects on depression symptoms. 30/35 studies were at high RoB.
CONCLUSIONS
Associations between reserpine and depression are inconsistent and limited by a lack of high-quality evidence. Due to reserpine's apparently complex effects, we urge nuance rather than simplicity surrounding the monoamine hypothesis of depression.
Topics: Adult; Humans; Depression; Reserpine; Antidepressive Agents; Anxiety; Anxiety Disorders
PubMed: 36000248
DOI: 10.1177/02698811221115762 -
Chemical Reviews Dec 2005
Review
Topics: Biological Products; Cyclization; Molecular Structure; Reserpine; Stereoisomerism
PubMed: 16351058
DOI: 10.1021/cr050521a -
Medizinische Klinik (Munich, Germany :... Dec 1998
Review
Topics: Diuretics; Drug Therapy, Combination; Humans; Hypertension; Reserpine; Treatment Outcome
PubMed: 10024843
DOI: 10.1007/BF03044812 -
Acta Neurovegetativa 1958
Topics: Reserpine
PubMed: 13605685
DOI: 10.1007/BF01226506 -
Journal of General Internal Medicine 1991
Review
Topics: Antihypertensive Agents; Benzothiadiazines; Cost Control; Diuretics; Drug Therapy, Combination; Humans; Hypertension; Reserpine; Sodium Chloride Symporter Inhibitors
PubMed: 1810301
DOI: 10.1007/BF02598229 -
Anesthesia and Analgesia Nov 1980
Topics: Aged; Female; Humans; Injections, Intravenous; Middle Aged; Reflex Sympathetic Dystrophy; Reserpine
PubMed: 7191680
DOI: 10.1213/00000539-198011000-00017 -
Journal of the American Pharmaceutical... Sep 1956
Topics: Reserpine
PubMed: 13357367
DOI: 10.1002/jps.3030450910 -
The New England Journal of Medicine Oct 1969
Topics: Animals; Bronchial Spasm; Humans; Reserpine
PubMed: 5812261
DOI: 10.1056/NEJM196910162811617 -
Life Sciences Nov 1976
Topics: Animals; Cross Reactions; Male; Methods; Radioimmunoassay; Rats; Reserpine
PubMed: 994735
DOI: 10.1016/0024-3205(76)90443-4 -
Pharmacology, Biochemistry, and Behavior Nov 1981Delta-9-tetrahydrocannabinol (THC), a substance in marihuana, was found to produce a profound potentiation of reserpine-induced hypokinesia in rats as measured with a...
Delta-9-tetrahydrocannabinol (THC), a substance in marihuana, was found to produce a profound potentiation of reserpine-induced hypokinesia in rats as measured with a bar test. In these experiments, THC had no hypokinetic effect by itself but produced a more than 20-fold increase in the hypokinesia produced by reserpine. Reserpine-induced hypokinesia has been viewed as animal model of Parkinson's Disease. THC potentiation of reserpine-induced hypokinesia was observed to be both time- and dose-dependent (1 to 10 mg/kg THC). When administered by gavage to reserpine-pretreated subjects (7.5 mg/kg IP, 24 hours before), THC produced a potentiation of hypokinesia that developed fully within 1 hour, lasted at least 5 hours, and was absent by 12 hours after THC administration. This THC effect was slightly increased by physostigmine, a cholinesterase inhibitor, relatively unaffected by scopolamine, a muscarinic antagonist, and almost completely blocked by ethopropazine, an anticholinergic antiparkinson drug. The effect was completely unaffected by naloxone. Insofar as reserpine has been used with some clinical efficacy in hyperkinetic movement disorders such as Huntington's disease and tardive dyskinesia, it may be that potentiation of reserpine's hypokinetic effect by a drug such as THC could greatly increase the clinical value of reserpine or related drugs in the treatment of these disorders.
Topics: Animals; Antiparkinson Agents; Catalepsy; Dose-Response Relationship, Drug; Dronabinol; Drug Synergism; Humans; Male; Motor Activity; Rats; Rats, Inbred Strains; Reserpine; Time Factors
PubMed: 6273940
DOI: 10.1016/0091-3057(81)90022-8