Reserpine withdrawal psychosis: the possible role of denervation supersensitivity of receptors.

A case is reported in which abrupt cessation of long term reserpine therapy for hypertension was followed by hallucinations and mania. Reserpine is thought to induce a denervation sensitivity to dopamine in the basal ganglia and chemotactic trigger zone in man and to catecholaminergic agents in the basal ganglia and mesolimbic system in animals. Conceivably, a parallel supersensitivity in the mesolimbic area could have occurred in this patient and accounted for the psychiatric symptoms. This supersensitivity and the possibility that it may, like tardive dyskinesia, be persistent should be considered when reserpine or similar drugs are used for prolonged periods.