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Discussion on Safe to stop reserpine?
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Member:
cmcrill
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Posted on Tuesday, Nov 16, 2010 - 1:32 pm:
My 12 year old gelding has been on reserpine orally for 6 months for a long rehab (hind suspensories). It has helped even out his moods for long stall rest with minimal turnout. Is it safe to just stop it suddenly after all this time, or do I need to taper it somehow?
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Moderator:
DrO
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Posted on Tuesday, Nov 16, 2010 - 2:42 pm:
Hello Connie,
How much are you giving how frequently?
DrO
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Member:
cmcrill
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Posted on Wednesday, Nov 17, 2010 - 9:52 pm:
3 mg powder orally each morning.
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Moderator:
DrO
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Posted on Thursday, Nov 18, 2010 - 4:43 pm:
Connie I have not had a horse on that dosage for that long and cannot find any warnings about withdrawal. The mode of action suggests that it may take time for the nervous system to adjust back to normal. You should consider following the recommendations from the person who prescribed the drug if he has a lot of experience in this area. In humans prolonged use and then abrupt withdrawal has caused problems:
J Nerv Ment Dis. 1982 Aug;170(8):502-4.
Reserpine withdrawal psychosis: the possible role of denervation supersensitivity of receptors.
Kent TA, Wilbur RD.
Abstract
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.
I cannot find any similar information available for horses. I certainly see no reason not to take it easy and come off slowly by reducing by 1 mg every 2 weeks and after two weeks of 1 mg and maybe even take it to 1/2 mg daily for 2 weeks before stopping. However I do not know for sure if this will avoid problems.
DrO
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Member:
cmcrill
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Posted on Thursday, Nov 18, 2010 - 9:26 pm:
Thanks very much for your response. That does make sense.
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