It is well recognized that reserpine, the crystalline alkaloid of Rauwolfia serpentina, can produce such undesirable effects as mental depression or Parkinsonism. An equally severe, but less well known, complication is acute upper gastrointestinal hemorrhage. Some patients in whom this has occurred have had a previous ulcer history,1 whereas others have not.2 Hollister2a reports hematemesis in a patient given 25 mg. of reserpine intramuscularly and 9 mg. orally over a five-day period. There had been no history suggesting peptic ulcer, and x-ray studies revealed only a hiatal hernia and enlarged rugae, no ulceration.
Lesser amounts for longer periods can produce the same results. Gailitis and co-workers2b describe three cases of acute gastrointestinal bleeding resulting from administration of 0.5 to 1.0 mg. of reserpine per day for 6 to 24 months in patients without any previous gastrointestinal disturbance. "Barium swallow" in two cases showed no pathology, but