Sarpagandha Uses In Ayurveda and Side Effects

Rauvolfia serpentina is known by many common names such as Serpentwood, The Himalayan snakeroot, Serpentina root, Serpentine root, Rauwolfia, Chandrabhaga and Sarpagandha. Sarpagandha is a medicinal plant and its leaves and roots are used mainly for therapeutic purpose. It is the main herb for hypertension.

The dried roots of plant are source of the pharmacologically important alkaloids such as reserpine, rescinnamine, deserpidine, ajamalacine, ajmaline, neoajmalin, serpentine, a-yohimbine. The plant received world recognition after isolation of alkaloid reserpine by Swiss scientists in year 1952 (Muller, Schlitter and Bain). Reserpine based medicines are prescribed as antihypertensive and antipsychotic drugs.

By Forestowlet - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34757318

---

The main biomedical action of the roots are alterative, antispasmodic, analgesic, carminative, hypotensive, nervine, sedative and vasodilatory. Roots are sedative due to presence of several alkaloids and used in treatment of mild to moderate hypertension (high blood pressure), stress, certain forms of insanity, insomnia and cardiac oedema. The bark, leaves, and roots are used against snake and scorpion poisoning. The juice of the leaves is used as a remedy for the removal of opacities of the cornea.

In Ayurvedic formulations, Sarpagandha is prescribed in treatment of high blood pressure, insomnia, asthma, acute stomach ache and painful delivery and for mental illness (neuropsychiatric disorders, psychosis, schizophrenia). It is used in snake-bite, insect stings, and mental disorders.

Sarpagandha, is also used in treatment of other diseases such as gastric tumor, general weakness, goiter, hysteria, insomnia, insanity, lipoma, paraplegia, paratyphoid, piles, pneumonia, splenomegaly, stomach disorder, tonsillitis, traumatic wound, tuberculosis and vertigo and pain in abdomen, body, and chest.

There is no doubt that Sarpgandha lowers blood pressure. It dilates blood vessel and has sedative effects. But it also causes many side effects. For example, alkaloid Reserpine has potent hypotensive and tranquillizer effect but its prolonged usage stimulates prolactine release and causes breast cancer. There are many other side effects of this herb including muscles relaxation, decrease of fertility, lowering of male hormones, abnormal heart rhythm, acidosis and shock. It must not be taken in ulcers, ulcerative colitis and depression.

Sarpagandha has depressive effects which can persist long after its use. So any one suffering from depression should not take its root powder. The most common side effects or negative effects on health include dizziness, headache, faintness, drowsiness, redness of eyes, dry mouth, diarrheas, impotence (erection problems), and low sex drive. The other less common side effects are irregular/slow heartbeat, chest pain, shortness of breath, stiffness, trembling of hands, swelling in feet and legs etc. Few rare side-effects include rash, skin itchiness, sore throat, fever, pain in abdomen, nausea, vomiting, Bleeding, nightmares, and urinary problems.

People suffering from epilepsy, and those who have given general or spinal anesthesia should take it only after consulting doctor. People above the age of 60 should avoid taking it as they are at the greater risk of suffering its side-effects.

Please read on to know benefits, harmful effects, side effects, drug interactions, contraindications of this medicinal. This page is intended to give right information about the herb, so that people can use it safely.

General Information

Rauvolfia is a perennial undershrub widely distributed in India in the sub- Himalayan tracts upto 1,000 m as well as, in the lower ranges of the Eastern and Western Ghats and in the Andamans.

It is an herbaceous perennial with a long, vertical, yellowish, somewhat tuberous, nodular rootstock and simple, woody stems, 30—60 cm high.

Leaves are simple, in whorls of 3, exstipulate, confined to the ends of branchlets, 7—13.5 cm long, 2.3—5 cm broad, lanceolate, tapering to both ends, undulate, glabrous, thin, light green, lateral veins 7—11 pairs, petioles 5—8 mm long.

Flowers are regular, bisexual, 1.3 cm diameter, on short pedicels 8 mm long, in rather close, irregular corymbose cymes, peduncle terminal, erect, glabrous, 1.5—3.5 cm long, bracts small, 2.5—3 mm long, 1 mm broad, filiform. Calyx segments 5, free, 3—3.5 mm long, 1—1.5 mm broad, linear, glabrous, acute or subacute ; corolla segments fused into a long, glabrous tube, about 2 cm long, pink, dilated 1.2 cm from base at insertion of stamens, above this corolla tube bent and of a lighter shade of pink, lobes 5,white or bright red, 6 mm long, 4 mm broad, oblong, rounded, convolute, contorted, overlapping anti-clockwise. Stamens 5, inserted above the middle of the corolla-tube.

Fruit a follicle, up to 0.8 cm long, more or less connate, minutely apiculate, glabrous, purplish-black when ripe.

The root pieces are mostly about 8 to 15 cm long and 0.5 to 2 cm in thickness, sub-cylindrical, curved, stout, thick and rarely branched. The outer surface greyish-yellow to brown with irregular longitudinal fissures. The rootlets are 0.1mm in diameter fracture, short, slight odour. The roots are bitter in taste.

The root powder is coarse to fine, yellowish-brown, free flowing, and has slight odour. There are simple to compound starch grains, calcium oxalate prisms and clusters.

Scientific Classification

The botanical name of is Rauvolfia serpentina. It belongs to plant family Apocynaceae and Genus Rauvolfia.

Family Apocynaceae mainly consists of trees, shrubs, or vines. There are about 155 genera and 2000 species distributed primarily in the tropics and subtropics. They are poorly represented in the temperate regions.

Few other medicinally important plants belonging to family Apocynaceae are Alstonia scholaris (Saptaparna), Catharanthus roseus (Sadabahar), Holarrhena antidysenterica (Kutaj), Nerium oleander (Kaner) and Wrightia tomentosa (Pala indigo plant or dyers's oleander).

Genus Rauvolfia is named in honor of German physician, Leonhard Rauwolf and consists of more than 100 species distributed throughout the world in moist tropical forests.

Below is given taxonomical classification of plant.

• Kingdom: Plantae – Plants
• Subkingdom: Tracheobionta – Vascular plants
• Superdivision: Spermatophyta – Seed plants
• Division: Magnoliophyta – Flowering plants
• Class: Magnoliopsida – Dicotyledons
• Subclass: Asteridae
• Order: Gentianales
• Family: Apocynaceae – Dogbane family
• Genus: Rauvolfia L. – devil's-pepper
• Species: Rauvolfia serpentina (L.) Benth. ex Kurz – serpentine wood

Synonym (s):

• Ophioxylon serpentinum L.
• Ophioxylon trifoliatum Gaertn.
• Tabernaemontana cylindracea Wall

Part(s) used for medicinal purpose: Roots with bark, roots and leaves

Plant type: Shrub

Native: Originated from South-East Asia, indigenous to India.

Distribution: Found in India including tropical Himalayas, from Punjab to Nepal, Sikkim, Bhutan, Assam, Western Ghats and the Andamans.

Also distributed in Bangladesh, Bhutan, Cambodia, China, Laos, Indonesia, Malaysia, Myanmar, Nepal, Pakistan, Sri Lanka and Vietnam.

Habitat: Tropical regions, in shady places among grass and as an undershrub in moist areas. It cannot stand the full open sun. In its natural habitat the plant thrives under the shade of forest trees or at the very edge of the forests where three of the four sides are protected against too intense sunlight. It grows more frequent under the shade of Sal (Shorea robusta), Haritaki (Terminalia chebula), Vibhitaki (Terminalia bellerica), Asna (Terminalia alata), Sisso (Dalbergia sisso), Khayar (Acacia catechu) and Karma (Adina cordifolia).

The plant grows in a wide variety of soils from sandy alluvial loam to red lateritic loam or stiff dark loam. The soil should be acidic with pH about 4.0-7.0.

Ecological adaptation: Grows in both evergreen and deciduous forests as undergrowth and also along the edge of the hill forests of high rainfall areas.

Plant status: Endangered

Flowering: from March to May and November.

Propagation and management: Propagated through seeds, root cuttings, root stumps and stem cuttings.

Safety Profile: UNSAFE in pregnancy.

Vernacular names / Synonyms

Latin name: Rauvolfia serpentina

Sanskrit: Nakuli, Chandrika, Chandramarah, Ahibhuka, Ahilata, Ahimardani, Bhadra, Bhujangakshi, Chandrasura, Chandrika, Charmahantri, Gandhanakuli, Ishwari, Karavi, Mahaahigandha, Mahasugandha, Nagagandha, Nagasugandha, Nakuladhya, Nakuleshta, Nakuli, Nandani, Patalaganda, Pashumahanakarika, Phanihantri, Raktapatrika, Sarpagandha, Sarpakshi, Sarpangi, Sarvagandha, Sugandha, Surasa, Surpadini, Suvaha, Vasara, Vasupushpa, Vishamardani, Vishamardanika,Vishanashini

Bengali: Chaandar, Chhoto Chadar, Chhoto Chand, Chandra, Sarpagandha

English: Rauvolfia Root, Serpentine or Serpentina Root

Gujrati: Amelpodee

Hindi: Chhotaa Chaand, Dhavalbaruaa, Nai, Nakulikanda

Kannada: Sutranaabhu, Sutranbhi

Malayalam: Amalpori

Marathi: Adkai, Chandra

Oriya: Dhanbarua, Sanochado

Tamil: Sarppaganti, Chivan amelpodi

Telugu: Sarpagandhi, Patalagandhi

Marma: Abomaraja, Bumraja, Bhomaraja, Bomangraja, Bong Mayaja Gach, Bong Maraja, Mahaga, Maiba Gach, Tuchro

Mandi: Do-grek-mi

Khumi: Mahaga

Tripura: Khungchak, Mahagay

Chakma: Bomara, Chota Chand, Chandra, Sarpagandha, Sursan, Surchan, Surshan

Garo: Badap, Durakmi

Urdu: Asrel

Nepal: Sarpagandha, Chandmaruwa, Dhaulebir

Chepang: Chyarangro

Trade name: Rauwolfia, Sarpagandha

Constituents of Rauvolfia serpentina

Rauvolfia serpentina Roots contain more than 50 indole alkaloids including the therapeutically important reserpine, deserpidine, rescinnamine and yohimbine. Others include ajmaline, ajmalinine, ajmalicine, serpentine, serpentinine, iso-ajmaline, reserpidine, raubasine, rauwolfinine and alstonine. Besides the alkaloids they contain rutin, oleoresin and a sterol, serpasterol, oleic acid and unsaturated alcohols. Stem bark and leaves contain small amounts of some of the above alkaloids and also rutin.

The alkaloids are classified into 3 groups

1. Reserpine (hypotensive, sedative and tranquillizing agent): Reserpine, rescinnamine, deserpine etc.

2. Ajmaline (stimulate central nervous system, respiration and intestinal movement with slight hypotensive action): Ajmaline, ajmalicine, ajmalinine, iso-ajmaline etc.

3. Serpentine (antihypertensive): Serpentine, sepentinine, alstonine etc.

Reserpine, Ajmalicine and rescinnamine are hypotensive and tranquilizer. Alkaloid Ajmaline is named after Hakin Ajmal Khan. Deserpidine is sedative, as well as hypotensive. Ajmaline exhibits antiarrhythmic activity. Reserpine has powerful sedative and depressant action.

The alkaloids of Sarpagandha roots

1. Acts on Vasomotor center and causes generalized vasodilation.

2. Depresses cerebral center and sooths nervous system.

3. Relax the blood vessels.

Other substances present include phytosterols, fatty acids, unsaturated alcohols and sugars.

Main action on Body

1. Blood pressure lowering
2. Depressive
3. Sedative
4. Tranquilizing

Ayurvedic Properties and Action of Sarpagandha

In Ayurveda, Sarpagandha consists of dried root of Rauwolfia serpentina (Linn.) Benth. ex Kurz. Sarpagandha means ‘smell of the snake’ and it is renowned as an antidote for poisonous snake bites. It is bitter and pungent in taste (Rasa), pungent after digestion (Vipaka), and is hot in effect (Virya).

Sarpagandha is pungent in both the initial and post-digestive tastes (Rasa and Vipaka) and gives relief in Vata and Kapha and increases pitta. It has property of digestion, vomiting and purging, and gives feeling of lightness. It is considered bad for sperms and fetus.

Rasa (taste on tongue): Katu (Pungent), Tikta (Bitter), Amla (Sour)

Guna (Pharmacological Action): Laghu (Light), Ruksha (Dry),

Virya (Action): Ushna (Heating)

Vipaka (transformed state after digestion): Katu (Pungent)

Srotas: Mental, nervous, circulatory and reproductive

It is a Katu Vipak herb. Vipak refers to post-digestive (effect after digestion / cooking of Rasa) effect of tastes after its mixing with digestive juices. It is the long term effect of herb. Katu Viapk herbs / foods, pungent after digestion. It increases dryness in body. Such foods reduce fertility and Kapha. Katu vipaak has catabolic effect on body.

Karma / Action

• Deepana: Promote appetite but do not aid in digesting undigested food
• Pachan: Assist in digesting undigested food, but do not increase the appetite
• Ruchikarak: Improve taste
• Kapha-Vata har: Remover of the Humor of Kapha-Vata
• Vishaghna: Poison-destroying
• Nidraprad: Sleep inducing
• Kamavasadaka: Depresses (avsadak) Kama (desire)
• Hridyavasadaka: Depresses (avsadak) Hridya (heart)

Sarpagandha is used in Ayurveda for Shula / pain, Anidra/insomnia, Apasmara/epilepsy, Bhut Badha /influence of evil spirits, psychotic disorder, Bhrama / hallucination, Jwar / fever, Krimiroga/intestinal parasites, Unmad/insanity, Yoni shula/ pain in vagina, Raktvikar/diseases of blood, Manas Roga/mental disorder, and Vrana.

Important Medicines

1. Sarpagandha Choornam
2. Sarpagandha Ghan Vati
3. Sarpagandha Vati
4. Serpasil Tablet
5. Serpina Himalaya
6. Reserpine Tablet

Reserpine Tablet (0.1 mg, 0.25 mg and 0.5mg)

Reserpine Tablet contains the insoluble alkaloid Reserpine, extracted from the roots of the plant Rauwolfia serpentina. It is antihypertensive, sedative and tranquillizer and contain the labeled amount of reserpine (C₃₃H₄₀N₂O₉) viz. 0.1 mg, 0.25 mg or 0.5mg.

Molecule formula: C₃₃H₄₀N₂O₉

Chemical name: (3β,16β,17α,18β,20α)-11,17-Dimethoxy-18-[(3,4,5-trimethoxybenzoyl)oxy]yohimban-16- carboxylic acid methyl ester.

Biological description of Reserpine: Irreversible vesicular monoamine transporter (VMAT2) antagonist. Long-lasting bioamine depleter. Prevents bioamine transport into synaptic vesicles and chromaffin granules. Depletes biogenic amine stores. Antihypertensive and antipsychotic.

It is taken orally with a glass of water in recommended doses.

This medicine should not be taken with Levodopa, Carbex, Eldepryl, Marplan, Nardil, and Parnate and Procarbazine.

It may interact with blood pressure medicines, Digoxin, breathing problem medicines, cold-congestion medicine and medicines for depression, anxiety, or psychotic disturbances.

Reserpine may cause Bad dreams, Diarrhea, Dry mouth, Headache, Loss of appetite, Nausea, vomiting, and Stuffy nose.

There can be some serious side-effects. In case of skin rash, itching or hives, swelling of the face, lips, or tongue , breathing problems, vision change, depression, lightheadedness, hearing problems, painful urinations, trouble sleeping and any other serious health issue contact doctor immediately.

Important Medicinal Properties of Sarpagandha

Rauvolfia serpentina is rich in medicinal properties. The understanding of these properties will help us to better utilize this herb. These also indicate the conditions in which we should avoid it. For example, it is Teratogenic and disturb the development of an embryo or fetus. It is Uterocontractant and starts contraction of uterus. Due to all these factor it must not be used in pregnancy.

Below is given medicinal properties along with the meaning.

• Antiandrogenic: Blocks the action of androgens (male sex hormones)
• Antiarrhythmic: Treat abnormal heart rhythms resulting from irregular electrical activity of the heart.
• Antifertility: Reduces fertility.
• Antipsychotic: Manage psychosis.
• Cardiodepressant: Decreases heart rate and contractility.
• CNS Depressant: Depresses, or slows, the sympathetic impulses of the central nervous system (respiratory rate, heart rate).
• Expectorant: Promotes the ejection of mucus
• Hypnotic: Sleep-inducing.
• Hypotensive: Lowers blood pressure
• Hypothyroid: Lowers thyroid.
• Narcotic: Affecting mood or behavior.
• Sedative: Causes depression of the central nervous system, which reduces mental activity.
• Teratogenic: Causing congenital anomalies or birth defects.
• Tranquilizer: Promotes tranquility.

Advantages / Benefits of Sarpagandha

1. This is the main herb for high blood pressure.
2. It dilates the blood vessels and reduces blood pressure.
3. It reduces Vata and gives relief in insomnia and agitation.
4. It is sedating and tranquillizing.
5. It is Brain tonic and given in combination with other brain nourishing herbs.
6. It gives relief in pain and colic.
7. It is an exceptionally powerful.

Disadvantages of Sarpagandha

1. It is hot in potency and has warming effect on body.
2. It can cause deformities in developing baby, if taken during pregnancy.
3. It can cause serious depression, tiredness and nasal congestion.
4. It may induce peptic ulceration.
5. It may aggravate allergic disorders.
6. Wrong dose can cause hypotension and lead to giddiness and sleepiness.
7. It can cause fluid retention.
8. It may increase salivation, nausea, vomiting and diarrhea.
9. Overdose may cause diarrhea, bradycardia and drowsiness.
10. Prolonged use can cause sterility.

Who should take Sarpagandha?

This herb is not for everyone. It can be given to people who are strong but highly irritable.

It is not meant for weak, lean, and depressive patient.

Medicinal Uses of Rauvolfia serpentina (Sarpagandha)

Sarpagandha has affinity for heart. It has vasodilatory properties and causes dropping of blood pressure. Its main indication is mild to moderate hypertension.

Sarpgandha formulations and reserpine are used in the management of essential hypertension and in certain neuropsychiatric disorders. For Hypertension, Heart diseases, Insomnia, Epilepsy, the root powder is taken in dose of half gram, twice a day.

1. Antihypertensive medicine

2. Antipsychotic medicine

Another important therapeutic use of the roots of Sarpagandha is in psychotic disorders such as delusions, hallucinations, schizophrenia, paranoia or disordered thought. Sarpagandha is sedative, narcotic and tranquilizing. The sedative and tranquillizing properties of the drug are thought to be related to depletion of catecholamine and serotonin from the brain.

It is used to get relief from various central nervous system disorders, anxiety states, excitement, maniacal behavior associated with psychosis, schizophrenia, insanity, insomnia, fits and epilepsy.

Combination of Rauvolfia serpentina, Nardostachys jatamansi and Tinospora cordifolia helps to induce better sleep in insomnia patients.

1. For all mental problems, one part Sarpgandha, three parts of Brahmi and two parts of Shankhpushpi are mixed to form a power. This powder is taken in dose of 1-3 grams, thrice a day. Or equal amount of Sarpgandha, Brahmi and Sankhpushpi are mixed and taken in dose of 250 mg thrice day.
2. For migraine, it is given in dose of 50mg to 100mg.
3. For fits, the root paste is taken in dose of 5 grams twice a day with water for one month.
4. The decoction of the roots is given to increase uterine contraction for expulsion of fetus in difficult cases.
5. It helps to get rid of intestinal parasite.
6. The juice of the leaves is used on the eyes to remove opacities of the cornea and consumptions of fresh small pieces lower the blood pressures.
7. It is used as a snake-bite remedy. Root Decoction and leaves is given to cure snakebite.
8. For snakebite, insectstings the root paste is applied at the affected area.
9. The root paste is applied topically to treat eczema (atopic dermatitis). Decoctions of the leaves is applied externally on scabies, ulcers and injuries.
10. For Stomach disorder, Root Juice, extracted by rubbing on stone, is taken twice a day for 3 days. Or the Leaf and flower Juice, extracted by smashing, is taken orally after boiling.
11. In Constipation, Root Juice, is taken directly three times a day for 2 weeks or the leaf juice is taken.
12. For arthritis, the roots of Sarpgandha and Chitrak/Plumbago are boiled in mustard oil. This oil is used for massaging the aching parts.

Dosage of Rauvolfia serpentina

• The Average dose is 500-600 mg corresponding to 6 mg total alkaloid once a day for 1-2 weeks. Then for maintenance 100 to 250 mg once a day is given.
• The tincture is taken in dose of 2–12 drops.
• The powdered root is given in dose of 20-30 grains.
• The root is given with a diuretic to prevent fluid retention which may develop if Rauvolfia root is given alone.

Remember, this herb directly affects heart. It has depressive action on the body organs. Therefore the dose must be properly controlled. High dose has negative effects. Wrong dose, can cause hypotension and lead to giddiness and sleepiness.

Contraindications, Interactions, Side-effects and Warnings Rauvolfia serpentina

1. It has teratogenic (disturb the development of an embryo or fetus) and abortifacient action and must not be used in pregnancy.
2. It is contraindicated in patients with a history of mental depression, bleeding disorders, gastric and Duodenal ulcers, pregnancy, breast-feeding, asthma, ulcers and kidney pain, decreased renal function, and in patients receiving Electroconvulsive therapy (ECTs). ECT formerly known as electroshock therapy, and often referred to as shock treatment, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses.
3. Side effects, include depression, dizziness, drowsiness, dyspnea, erectile dysfunction, lethargy, rash, and reactive changes (dangerous while driving), reduced sexual potency, and stuffy nose.
4. Drug interactions occurs with appetite suppressants, barbiturates, digitalis glycosides, levodopa, neuroleptics, and sympathomimetics.
5. When taken with cough / flu medicines or with appetite lowering medicine it causes significant initial increase of blood pressure.
6. Do not use with selective serotonin reuptake inhibitors, beta-blockers, levodopa, tricyclic and antidepressants.
7. It should not be used with alcohol as it severely increases the impairment of motor reactions.
8. Excessive dose causes drowsiness, weak-slow pulse, slow breathing, diarrhea, lower body temperature and contraction of pupils.
9. It is banned for use in the UK unless prescribed by a doctor.
10. Only to be used under the guidance of doctor as it can cause severe reactions.