Trial Of Reserpine In Treatment Of Schizophrenia

Abstract

Reserpine given orally may benefit deteriorated chronic hospitalized schizophrenics with troublesome symptoms. Chronic schizophrenics who have failed to achieve a sustained remission following E.C.T., insulin coma, or leucotomy may improve remarkably with intensive reserpine therapy. As a result of our experience we have made it a rule that no schizophrenic should be leucotomized without first having prolonged trial on reserpine. Patients with schizophrenia of insidious onset but without florid symptoms or gross personality deterioration may respond favourably to intensive reserpine therapy. It is probably necessary to continue on an oral maintenance dose for a prolonged period. Immediate results of reserpine therapy in acute schizophrenics are impressive. Observation over a prolonged period alone can determine whether in these early cases it is a better therapeutic agent than insulin coma therapy. Severe depression of the endogenous type with characteristic early morning waking and suicidal preoccupation is the most serious complication of the treatment. The incidence of this complication was greatest in the schizo-affective type of psychosis. A past history of endogenous depression is a contraindication to the use of the drug. Some chronic schizophrenics improve on oral dosage only. Intensive and prolonged treatment seems necessary in most cases of progressive schizophrenia. Some patients with chronic anxiety states, especially if underweight, may benefit from oral reserpine. The results in most cases are not so dramatic as in schizophrenia. Most patients on reserpine eat better and put on weight. Cases of anorexia nervosa may improve rapidly on the drug. The extensive use of reserpine alters the character of a psychiatric unit considerably. Negativistic, aggressive behaviour is greatly diminished. Patients can enjoy more freedom and take a more active part in the hospital routine. It places an increased demand on hospital staff for individual psychotherapy. © 1957, British Medical Journal Publishing Group. All rights reserved.