Yohimbe

Aphrodien, Corynanthe yohimbi, corynine, Pausinystalia yohimbe, yohimbehe, yohimbine

The bark of the West African yohimbe tree (pausinystalia yohimbe) is rich in the alkaloid yohimbine, and both the crude bark and purified compound have long been hailed as aphrodisiacs. The bark has been smoked as a hallucinogen and has been used in traditional medicine to treat angina and hypertension. Today the drug is being investigated for the treatment of organic impotence. Yohimbe contains tannins and 2.7% to 5.9% indole alkaloids, especially yohimbine. Other alkaloids include ajamalicine, dihydroyohimbine, corynantheine, and others. Effects of yohimbine are mediated mostly via selective blockade of alpha2 receptors, primarily in the central nervous system (CNS). At higher levels, yohimbine acts as an agonist at alpha1, serotonin, and dopamine receptors. Yohimbine may also inhibit monoamine oxidase (MAO) and slow L-type calcium channels in heart and blood vessels.

Yohimbe increases penile cavernous blood flow in men with erectile dysfunction. It also increases autonomic nerve activity from the brain to genital tissues and increases reflex excitability in the sacral region of the spinal cord. It’s available as tablets and tinctures, in products such as Aphrodyne, Day to Himbin, Potensan, Yobinol, Yocon, Yohimbine HCL, Yohimbe Power MAX for Women, and Yohimmex.

Reported uses

Yohimbe is primarily used as an aphrodisiac and to treat organic and psychogenic erectile dysfunction in men. It’s also used at higher doses to treat orthostatic hypotension.

Administration

For erectile dysfunction, dosage is 5.4 mg by mouth three times a day. Doses of 20 to 30 mg have been shown to significantly increase blood pressure. Yohimbe bark alcoholic extracts are usually standardized to contain a certain amount of yohimbine.

Hazards

As per https://www.reviewswell.com/, yohimbe may cause nervousness, anxiety, irritability, increased motor activity, headache, anorexia, dizziness, insomnia, manic or psychotic episodes, paralysis, tachycardia, hypotension, hypertension, abdominal discomfort, diarrhea, nausea, and acuterenal failure.

Yohimbe may precipitate clonidine withdrawal hypertensive crisis when used with antihypertensives, including adrenergics and clonidine. It may block the action of anxiolytics. Yohimbe may enhance the effects of CNS-stimulating drugs, including tricyclic antidepressants and selective serotonin reuptake inhibitors. Naltrexone may increase the patient’s sensitivity to yohimbe, potentiating adverse reactions. Yohimbe may enhance the effects of caffeine. Because of its reported weak MAO-inhibiting activity, yohimbe may interact with tyraminecontaining foods. There may be additive effects if yohimbe is used with alcohol.

Yohimbe shouldn’t be used by children, geriatric patients, pregnant women, breast-feeding women, and people with psychiatric disorders, liver disease, kidney disease, hyperthyroidism, angina pectoris, or cardiovascular disease, especially hypertension.

Clinical considerations

  • Yohimbe is used mainly by men to help with impotence, but some women may take it for an aphrodisiac effect.
  • Be alert for possible CNS and blood pressure changes.
  • Yohimbe can significantly increase blood pressure in patients with orthostatic hypotension caused by autonomic failure or multisystem atrophy.
  • Follow patient’s vital signs and electrocardiogram closely.
  • Monitor patient for adverse effects or changes in condition.
  • Inform patient that yohimbe is considered by many to have a high risk-to-benefit ratio.
  • Instruct patient not to take caffeine products while also taking yohimbe.
  • Warn patient not to take yohimbe for erectile dysfunction before seeking medical attention because doing so may delay diagnosis of a potentially serious medical condition.
  • Instruct patient to report adverse effects promptly to a health care provider.
  • Warn patient to keep all herbal products away from children and pets.
  • Tell patient to remind pharmacist of any herbal and dietary supplements that are being taken when filling a new prescription.
  • Advise patient to consult with a health care provider before using an herbal preparation because a conventional treatment with proven efficacy may be available.

Research summary

Yohimbe is currently approved by the FDA as a drug, but has no FDA sanctioned indications. Some types of impotence have successfully been treated with yohimbine, but data are sparse and adverse reactions can be severe. Herbal use of yohimbe is potentially more dangerous owing to varying amounts of the alkaloid yohime in different preparations.