Editing Reserpine (section)

==Medical uses==
Reserpine is recommended as an alternative drug for treating hypertension by the JNC 8.<ref>{{cite journal | vauthors = James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E | title = 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8) | journal = JAMA | volume = 311 | issue = 5 | pages = 507–20 | date = February 2014 | pmid = 24352797 | doi = 10.1001/jama.2013.284427 | doi-access =  }}</ref> A 2016 Cochrane review found reserpine to be as effective as other first-line antihypertensive drugs for lowering of blood pressure.<ref>{{cite journal | vauthors = Shamon SD, Perez MI | title = Blood pressure-lowering efficacy of reserpine for primary hypertension | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 12 | pages = CD007655 | date = December 2016 | pmid = 27997978 | pmc = 6464022 | doi = 10.1002/14651858.CD007655.pub3 }}</ref> The reserpine–thiazide diuretic combination is one of the few drug treatments shown to reduce mortality in [[randomized controlled trials]]: The Hypertension Detection and Follow-up Program,<ref name="pmid490882">{{cite journal | vauthors = <!-- No authors listed --> | title = Five-year findings of the hypertension detection and follow-up program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension. Hypertension Detection and Follow-up Program Cooperative Group | journal = JAMA | volume = 242 | issue = 23 | pages = 2562–71 | date = December 1979 | pmid = 490882 | doi = 10.1001/jama.242.23.2562 }} [http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=490882.ui full text at OVID]</ref> the Veterans Administration Cooperative Study Group in Anti-hypertensive Agents,<ref name="pmid4862069">{{cite journal | vauthors = <!-- No authors listed --> | title = Effects of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129 mm Hg | journal = JAMA | volume = 202 | issue = 11 | pages = 1028–34 | date = December 1967 | pmid = 4862069 | doi = 10.1001/jama.202.11.1028 }}</ref> and the Systolic Hypertension in the Elderly Program.<ref name="pmid2046107">{{cite journal | vauthors =  | title = Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group | journal = JAMA | volume = 265 | issue = 24 | pages = 3255–64 | date = June 1991 | pmid = 2046107 | doi = 10.1001/jama.265.24.3255 }}</ref> Moreover, reserpine was included as a secondary antihypertensive option for patients who did not achieve blood pressure lowering targets in the ALLHAT study.<ref name="allhat">{{cite journal | author = ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial | title = Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) | journal = JAMA | volume = 288 | issue = 23 | pages = 2981–97 | date = December 2002 | pmid = 12479763 | doi = 10.1001/jama.288.23.2981 | url = http://jama.ama-assn.org/cgi/content/full/288/23/2981 | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20091126004644/http://jama.ama-assn.org/cgi/content/full/288/23/2981 | archive-date = November 26, 2009 | url-access = subscription }}</ref>

It was previously used to treat symptoms of [[dyskinesia]] in patients with [[Huntington's disease]],<ref name="pharmnemonics">{{Cite book|author=Shen, Howard|title=Illustrated Pharmacology Memory Cards: PharMnemonics|publisher=Minireview|year=2008|isbn=978-1-59541-101-3|page=11}}</ref> but alternative medications are preferred today.<ref>{{cite journal | vauthors = Thanvi B, Lo N, Robinson T | title = Levodopa-induced dyskinesia in Parkinson's disease: clinical features, pathogenesis, prevention and treatment | journal = Postgraduate Medical Journal | volume = 83 | issue = 980 | pages = 384–8 | date = June 2007 | pmid = 17551069 | pmc = 2600052 | doi = 10.1136/pgmj.2006.054759 }}</ref>

The daily dose of reserpine in antihypertensive treatment is as low as 0.05 to 0.25&nbsp;mg. The use of reserpine as an [[antipsychotic]] drug had been nearly completely abandoned, but more recently it made a comeback as adjunctive treatment, in combination with other antipsychotics, so that more refractory patients get dopamine blockade from the other antipsychotic, and dopamine depletion from reserpine. Doses for this kind of adjunctive goal can be kept low, resulting in better tolerability. Originally, doses of 0.5&nbsp;mg to 40&nbsp;mg daily were used to treat psychotic diseases.

Doses in excess of 3&nbsp;mg daily often required use of an anticholinergic drug to combat excessive cholinergic activity in many parts of the body as well as parkinsonism. For adjunctive treatment, doses are typically kept at or below 0.25&nbsp;mg twice a day.