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Yohimbe


What is it?

Yohimbe is the name of an evergreen tree that is found in Zaire, Cameroon, and Gabon. The bark of yohimbe contains a chemical called yohimbine, which is used to make medicine.

Yohimbe is used to arouse sexual excitement, for erectile dysfunction (ED), sexual problems caused by medications for depression called selective-serotonin reuptake inhibitors (SSRIs), and general sexual problems in both men and women. It is also used for athletic performance, weight loss, exhaustion, chest pain, high blood pressure, low blood pressure that occurs when standing up, diabetic nerve pain, and for depression along with certain other medications.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for YOHIMBE are as follows:

Insufficient evidence to rate effectiveness for...

  • Anxiety. There is mixed evidence about the effectiveness of yohimbine, the active ingredient in yohimbe, for treating anxiety related to phobias. Some research suggests that it does not improve anxiety when combined with therapy. However, other research suggests that it reduces fear related to certain phobias.
  • Depression. Early research suggests that taking yohimbine, the active ingredient of yohimbe, daily for 10 days does not improve depression symptoms.
  • Erectile dysfunction (ED). There is evidence that yohimbine, the active ingredient of yohimbe, can be helpful for ED. Some herbalists suggest that the yohimbe bark actually works better than the yohimbine ingredient alone. However, so far yohimbe bark has not been evaluated in research studies.
  • Exercise performance. Early research suggests that taking yohimbine, the active ingredient in yohimbe, daily for 21 days does not improve exercise performance or build muscle mass in soccer players.
  • Head rush (orthostatic hypotension). Early research suggests that taking a single dose of yohimbine, the active ingredient in yohimbe, increases blood pressure in people with a head rush due to low blood pressure. However, other early research suggests that it does not improve blood pressure.
  • Sexual problems caused by selective-serotonin reuptake inhibitors (SSRIs). There is evidence from many studies that yohimbine, the active ingredient of yohimbe, can improve sexual problems associated with this class of medications used for depression. However, this benefit has not been described specifically for the yohimbe bark.
  • Dry mouth. Early research suggests that taking yohimbine, the active ingredient in yohimbe, improves symptoms of dry mouth in people taking antidepressants. The effect of the yohimbe bark on dry mouth is not clear.
  • Exhaustion.
  • Chest pain.
  • Diabetic complications.
  • Other conditions.
More evidence is needed to rate yohimbe for these uses.

How does it work?

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Yohimbe contains a chemical called yohimbine which can increase blood flow and nerve impulses to the penis or vagina. It also helps counteract the sexual side effects of certain medications used for depression.

Are there safety concerns?

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Yohimbe, taken by mouth, is POSSIBLY UNSAFE. Yohimbe has been linked to reports of severe side effects including irregular or rapid heart beat, kidney failure, seizure, heart attack, and others.

The primary active ingredient in yohimbe is a drug called yohimbine. This is considered a prescription drug in North America. This drug can be safely used short-term when monitored by a health professional. However, it is not appropriate for unsupervised use due to potentially serious side effects that it can cause.

Children should not take yohimbe. It is POSSIBLY UNSAFE for children because children appear to be extra sensitive to the harmful effects of yohimbe.

When taken by mouth in typical doses, yohimbe and the ingredient yohimbine can cause stomach upset, excitation, tremor, sleep problems, anxiety or agitation, high blood pressure, a racing heartbeat, dizziness, stomach problems, drooling, sinus pain, irritability, headache, frequent urination, bloating, rash, nausea, and vomiting.

Taking high doses can also cause other severe problems, including difficulty breathing, paralysis, very low blood pressure, heart problems, and death. After taking a one-day dose of yohimbine, one person reported an allergic reaction involving fever; chills; listlessness; itchy, scaly skin; progressive kidney failure; and symptoms that looked like the auto-immune disease called lupus.

Special precautions & warnings:

Pregnancy or breast-feeding: Yohimbe is LIKELY UNSAFE. Yohimbe might affect the uterus and endanger the pregnancy. It might also poison the unborn child. Don’t take yohimbe if you are pregnant or breast-feeding.

Bleeding conditions: Taking yohimbe might increase the risk of bleeding in people with bleeding disorders.

Schizophrenia: Use yohimbe with caution. The yohimbine in yohimbe might make people with schizophrenia psychotic.

Prostate problems: Use yohimbe with caution. Yohimbe might make the symptoms of BPH (benign prostatic hyperplasia) worse.

Post-traumatic stress disorder (PTSD): Don’t use yohimbe. There is a report that four individuals with PTSD suffered worse symptoms after using yohimbe.

Liver disease: Don’t use yohimbe. Liver disease might change the way the body processes yohimbe.

Kidney disease: Don’t use yohimbe. There is a concern that yohimbine might slow or stop the flow of urine.

High blood pressure or low blood pressure: Don’t use yohimbe. Small amounts of yohimbine can increase blood pressure. Large amounts can cause dangerously low pressure.

Chest pain or heart disease: Don’t use yohimbe. Yohimbine can seriously harm the heart.

Anxiety: Don’t use yohimbe. Yohimbine might make anxiety worse.

Depression: Don’t use yohimbe. Yohimbine might bring out manic-like symptoms in people with bipolar depression or suicidal tendencies in individuals with depression.

Diabetes: Don’t use yohimbe. Yohimbe might interfere with insulin and other medications used for diabetes and cause low blood sugar.

Surgery: Yohimbe might increase the risk for bleeding. People who take yohimbe should stop at least 2 weeks before surgery.

Are there interactions with medications?

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Major

Do not take this combination.

Medications for depression (MAOIs)
Yohimbe contains a chemical that affects the body. This chemical is called yohimbine. Yohimbine might affect the body in some of the same ways as some medications for depression called MAOIs. Taking yohimbe along with MAOIs might increase the effects and side effects of yohimbe and MAOIs.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Moderate

Be cautious with this combination.

Clonidine (Catapres)
Clonidine (Catapres) is used to decrease blood pressure. Yohimbe might increase blood pressure. Taking yohimbe along with clonidine (Catapres) might decrease the effectiveness of clonidine (Catapres).

Guanabenz (Wytensin)
Yohimbe contains a chemical called yohimbine. Yohimbine can decrease the effectiveness of guanabenz (Wytensin).

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the liver. Yohimbe might decrease how quickly the liver breaks down some medications. Taking yohimbe along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking yohimbe talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), dextromethorphan, donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Medications for depression (Tricyclic antidepressants)
Yohimbe can affect the heart. Some medications used for depression called tricyclic antidepressants can also affect the heart. Taking yohimbe along with these medications used for depression might cause heart problems. Don't take yohimbe if you are taking these medications for depression.

Some of these tricyclic antidepressants medications used for depression include amitriptyline (Elavil), imipramine (Tofranil), and others.

Medications for high blood pressure (Antihypertensive drugs)
Yohimbe seems to increase blood pressure. Taking yohimbe along with some medications for high blood pressure might decrease the effectiveness of medications for high blood pressure.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Yohimbe might slow blood clotting. Taking yohimbe along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Naloxone (Narcan)
Yohimbe contains a chemical that can affect the brain. This chemical is called yohimbine. Naloxone (Narcan) also affects the brain. Taking naloxone (Narcan) along with yohimbine might increase the chance of side effects such as anxiety, nervousness, trembling, and hot flashes.

Phenothiazines
Yohimbe contains a chemical called yohimbine. Some medications called phenothiazines have some similar effects to yohimbine. Taking yohimbe along with phenothiazines might increase the effects and side effects of yohimbine.

Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others.

Stimulant drugs
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Yohimbe might also speed up the nervous system. Taking yohimbe along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with yohimbe.

Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Are there interactions with herbs and supplements?

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Berberine
Berberine seems to decrease blood pressure. Yohimbe might increase blood pressure. Taking yohimbe along with berberine might reduce the effects of yohimbe or berberine on blood pressure.

Caffeine-containing herbs and supplements
There is a concern that using yohimbe along with large amounts of herbs or products that contain caffeine might increase the risk of developing dangerously high blood pressure. Caffeine-containing herbs include coffee, cola, guarana, mate, and tea.

Ephedra
There is a concern that using yohimbe along with large amounts of ephedra might increase the risk of dangerously high blood pressure because of the ephedrine in ephedra.

Herbs and supplements that might slow blood clotting
Using yohimbe along with herbs that can slow blood clotting might increase the risk of bleeding in some people. These herbs angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.

Are there interactions with foods?

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Foods that can narrow the blood vessels
Don't take yohimbe along with large amounts of foods that can narrow the blood vessels. This combination might increase the risk of developing dangerously high blood pressure. Foods that can narrow the blood vessels include overripe fava beans, coffee, tea, colas, and chocolate.

Foods that contain tyramine
Don't take yohimbe along with foods that contain a lot of the chemical tyramine. It might increase the risk of developing dangerously high blood pressure. Foods that contain tyramine include aged cheeses, fermented meats, red wines, and others.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For problems with sexual performance: 15-30 mg daily of yohimbine, the active ingredient in yohimbe. Doses of up to 100 mg of yohimbine daily have been used. However, significant side effects, some quite dangerous (including the possibility of death), would be expected with such a high dose.

Other names

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11-hydroxy Yohimbine, Alpha Yohimbine HCl, Coryanthe Yohimbe, Corynanthe Johimbe, Corynanthe johimbi, Corynanthe yohimbi, Johimbi, Pausinystalia yohimbe, Pausinystalia johimbe, Yohimbehe, Yohimbehe Cortex, Yohimbine, Yohimbine HCl, Yohimbinum Muriaticum.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Yohimbe page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/759.html.

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Last reviewed - 10/27/2014




Page last updated: 10 December 2014