Reserpine treatment of Raynaud's disease

Six patients with primary Raynaud's disease were investigated with magnification hand arteriography, measurement of finger systolic pressure and response to a newly devised local cooling test. They were treated with reserpine 0.5 mg injected into the brachial artery, and the clinical effects were followed by a scoring system and by the change in digital arterial tone during local cooling. The latter was registered as the change in systolic finger blood pressure measured indirectly by a finger-plethysmograph during stepwise decrease in finger temperature, until at a critical temperature complete closure of the digital arteries occurred. Shortly after injection the clinical condition improved, and closure of the digital arteries during local cooling was impeded. But within a week the cooling test showed a transient deterioration with closure of the digital arteries at the same or a somewhat higher temperature than before the reserpine injection. The clinical score followed this trend. According to animal experiments the shortlasting vascular effect of reserpine on primary Raynaud's disease might be due to depletion of the sympathetic nerve terminals for norepinephrine.