Although Rauwolfia serpentina has been known and widely used for emotional disturbances in India for many centuries, it was only about ten years ago that Vakil (1) noted additional beneficial effects in human hypertension. Three years later, Muller, Schlittler and Bein (2) isolated the pure crystalline alkaloid, reserpine, which exhibited similar pharmacologic principles. Bein (3) in 1953 and Plummer et al. (4) in 1954 extended the pharmacologic attributes to include quieting and reduction of emotional responses, lowering of blood pressure with bradycardia, miosis, relaxation of the nictitating membrane and hypothermia-all being consistent with reduced predominance of the sympathetic division of the autonomic nervous system.Thirty-five different alkaloids have been isolated from various Rauwolfia species but only a few of them possess enough pharmacologic activity to make their use practical. Clinically, Rauwolfia and its active alkaloids such as deserpidine and rescinnamine, have certain desirable hypotensive and sedative effects. However, in addition to their pharmacologic action on the cardiovascular and central nervous systems, these agents produce varying degrees of undesirable side-reactions such as nasal congestion, lethargy, depression, gastrointestinal upsets (diarrhea), dizziness, cold sweats, confusion, nightmares and diurnal somnolence.It has been thought that two of the effects of reserpine -hypotension and sedation-were inseparable. However, Plummer et al. (5) recently noted that the sedative effect could be eliminated in dogs given a stimulant, methylphenidate (Ritalin)', without altering the hypotensive effect. Thus a search for possible modification of reserpine, began. It was hoped that removal of the sedative factor would lessen complaints of lethargy and depression and also reduce some of the other side-effects to a minimum.A series of chemical modifications were made by replacing different organic acids at the trimethoxybenzoic-acid portion of reserpine (6). As a result, a new substance was found which had the cardiovascular effects of reserpine, yet had minimal sedating activity. This substance (carbethoxysyringoyl methylre-1 Ritalin = methylphenidate hydrochloride, CIBA. 648