Ram Nath Chopra (1882–2002), Robert Wallace Wilkins (1906–2003), Rustom Jal Vakil (1911–1974), Nathan S. Kline (1916–1982)
The snakeroot plant, Rauwolfia serpentina, was long an integral component of Indian Ayurvedic medicine. During the 1930s and 1940s, scientific and clinical studies conducted in India by Ram Nath Chopra and Rustom Jal Vakil focused attention on the effects of the root on high blood pressure (hypertension) and mental disorders—in particular, schizophrenia. In addition to the clinical studies by these respected scholars, interest in rauwolfia was heightened by the paucity of safe and effective drugs for these conditions in 1950. That year, studies by Robert Wallace Wilkins at Massachusetts General Hospital first established in Western medicine rauwolfia’s effectiveness for mild hypertension. However, early enthusiasm waned when far better antihypertensive drugs, with fewer side effects, appeared during the 1960s.
In 1952, the Basel-based pharmaceutical company Ciba announced the isolation of reserpine (Serpasil), the primary alkaloid responsible for rauwolfia’s effects. Extensive clinical trials by Nathan S. Kline at Rockland State Hospital in New York established reserpine’s ability to reduce symptoms in schizophrenic patients, and for several years during the mid-1950s, it enjoyed considerable popularity for this condition. However, the timing of its introduction was inopportune. Chlorpromazine (Thorazine), which had made its appearance for the treatment of schizophrenia in 1952, was a more effective and efficient drug. And unlike reserpine, it did not cause depression.
Reserpine-induced depression, which led to suicide in some patients, spelled the drug’s demise as an anti-schizophrenic drug. Instead, reserpine embarked on a noncommercial career as a tool in the formulation of theories on the biochemical bases of depression and schizophrenia. Studies in animals showed that reserpine depleted serotonin, norepinephrine, and dopamine, neurotransmitters collectively called biogenic amines. Depression has been hypothesized to be associated with a deficiency of norepinephrine and serotonin, while schizophrenia may involve excessive dopamine. Thus, the research tool has superseded the medicine in importance.
SEE ALSO Rauwolfia (c. 500 BCE), Alkaloids (1806), Neurotransmitters (1920), Chlorpromazine (1952), Prozac (1987).
The goal of Ayurvedic medicine—of which rauwolfia and its primary alkaloid, reserpine, are an integral component—is to prevent disease by achieving balance of the three energy types (doshas). This pharmacy in Rishikesh, the gateway to the Himalayas, is located in northern India.