RESERPINE

Drugs in Pregnancy and Lactation.

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Name: RESERPINE
Class: Antihypertensive
Risk Factor:    CM

Fetal Risk Summary

The Collaborative Perinatal Project monitored 50,282 mother-child pairs, 48 of which had 1st trimester exposure to reserpine (1, p. 376). There were four defects with 1st trimester use. Although this incidence (8%) is greater than the expected frequency of occurrence, no major category or individual malformations were identified. For use anytime in pregnancy, 475 exposures were recorded (1, p. 441). Malformations included the following: Microcephaly (7 cases) Hydronephrosis (3 cases) Hydroureter (3 cases) Inguinal hernia (12 cases) Incidence of these latter malformations was not found to be statistically significant (1, p. 495).

Reserpine crosses the placenta. Use of reserpine near term has resulted in nasal discharge, retraction, lethargy, and anorexia in the newborn (2). Concern over the ability of reserpine to deplete catecholamine levels has appeared (3). The significance of this is not known.

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 15 newborns had been exposed to reserpine during the 1st trimester (F. Rosa, personal communication, FDA, 1993). No major birth defects were observed (one expected).

Breast Feeding Summary

Reserpine is excreted into breast milk (4). No clinical reports of adverse effects in the nursing infant have been located.

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References

  1. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977.
  2. Budnick IS, Leikin S, Hoeck LE. Effect in the newborn infant to reserpine administration ante partum. Am J Dis Child 1955;90:286–9.
  3. Towell ME, Hyman AI. Catecholamine depletion in pregnancy. J Obstet Gynaecol Br Commonw 1966;73:431–8.
  4. Product information. Serpasil. Ciba Pharmaceutical, 1993.

Index

Q&A about Reserpine

adiya120...
What is the pattern of weight gain amogst psychotics on treatment with Reserpine?
The pattern of weight gain amongst Schizophrenics on administration of reserpine
jonnyrai...
Reserpine emerged in the first generation of psychoactive medications, along with chlorpromazine, that had demonstrably beneficial effects in the treatment of schizophrenia. It is no longer used virtually anywhere in the world for the treatment of schizophrenia, other psychotic disorders, or depression. It was used fairly widely in the 1950's and 60's, but it has since been superceded by other drugs with greater efficacy and fewer side effects. Weight gain was one of the side effects seen in some patients treated with reserpine, but vomiting and diarrhea leading to weight loss also occurred. Reserpine today is considered far too crude a medication for clinical applications almost anywhere. The only exception is its use in some parts of the world as an antihypertensive agent, but here again there are much better, safer drugs available for this purpose.
lost in class
ether functional groups found in reserpine?
Sips With A Fist
There are one alkylmethyl and four arylmethyl ether groups.

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