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    Yohimbe

    Yohimbe

    Uses

    Common names:
    Yohimbine
    Botanical names:
    Pausinystalia yohimbe

    Parts Used & Where Grown

    Yohimbe is a tall evergreen forest tree native to southwestern Nigeria, Cameroon, Gabon, and the Congo. The bark of this African tree is used medicinally. There are concerns, however, that the tree may be endangered due to over-harvesting for use as medicine.

    What Are Star Ratings?

    Our proprietary ?Star-Rating? system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    This supplement has been used in connection with the following health conditions:

    Used for Why
    3 Stars
    Erectile Dysfunction
    5 to 10 drops three times per day, under a doctor's supervision
    Learn More

    Yohimbine (the primary active constituent in yohimbe ) has been shown in several double-blind trials to help treat men with ED;2 , 3 negative results have also been reported, however.4 , 5 Yohimbe dilates blood vessels and may help, regardless of the cause of ED. A tincture of yohimbe bark is often used in the amount of 5 to 10 drops three times per day. Standardized yohimbe extracts are also available. A typical daily amount of yohimbine is 15 to 30 mg. It is best to use yohimbe and yohimbine under the supervision of a physician.

    2 Stars
    Obesity
    Take under medical supervision: enough to supply 5 mg of yohimbine four times per day
    Learn More

    The ability of yohimbine, a chemical found in yohimbe bark, to stimulate the nervous system, 6 , 7 and to promote the release of fat from fat cells,8 , 9 has led to claims that it might help weight loss by raising metabolic rate, reducing appetite, or increase fat burning. Although a preliminary trial found yohimbine ineffective for weight loss, a double-blind study found that women taking 5 mg of yohimbine four times per day along with a weight-loss diet lost significantly more weight than those taking a placebo with the same diet after three weeks.10 However, a similar study using 18 mg per day of yohimbine for eight weeks reported no benefit to weight loss compared with a placebo.11 A double-blind study of men who were not dieting reported no effect of up to 43 mg per day of yohimbine on weight or body composition after six months.12 All of these studies used pure yohimbine; no study has tested the effects of yohimbe herb on weight loss.

    1 Star
    Athletic Performance
    Refer to label instructions
    Learn More

    The ability of yohimbine , a chemical found in yohimbe bark, to stimulate the nervous system,13 , 14 promote the release of fat from fat cells,15 , 16 and affect the cardiovascular system 17 has led to claims that yohimbe might help athletic performance or improve body composition. However, a double-blind study of men who were not dieting reported no effect of up to 43 mg per day of yohimbine on weight or body composition after six months.18 No research has tested yohimbe herb for effects on body composition, and no human research has investigated the ability of yohimbine or yohimbe to affect athletic performance. Other studies have determined that a safe daily amount of yohimbine is 15 to 30 mg.19 However, people with kidney disorders should not take yohimbe, and side effects of nausea, dizziness, or nervousness may occur that necessitate reducing or stopping yohimbe supplementation.

    1 Star
    Depression
    Refer to label instructions
    Learn More

    Damiana has traditionally been used to treat people with depression. Yohimbine (the active component of the herb yohimbe ) inhibits monoamine oxidase (MAO) and therefore may be beneficial in depressive disorders. However, clinical research has not been conducted for its use in treating depression.

    Traditional Use (May Not Be Supported by Scientific Studies)

    Historically, yohimbe bark was used in western Africa for fevers, leprosy, and coughs .1 It has also been used to dilate pupils, for heart disease , and as a local anesthetic. It has a more recent history of use as an aphrodisiac and a hallucinogen.

    How It Works

    Common names:
    Yohimbine
    Botanical names:
    Pausinystalia yohimbe

    How It Works

    The alkaloid known as yohimbine is the primary active constituent in yohimbe, although similar alkaloids may also play a role. Yohimbine blocks alpha-2 adrenergic receptors, part of the sympathetic nervous system.20 It also dilates blood vessels. Yohimbine inhibits monoamine oxidase (MAO) and therefore may theoretically be of benefit in depressive disorders. However, it does not have the clinical research of other herbs used for depression , such as St. John?s wort .

    Yohimbine has been shown in double-blind trials to help treat men with erectile dysfunction .21 , 22 Although, negative studies have also been reported.23 , 24

    How to Use It

    Standardized yohimbe products are available. A safe daily amount of yohimbine from any product is 15?30 mg.25 Yohimbine should be used under the supervision of a physician. Traditionally, a tincture of the bark, 5?10 drops three times per day, has been used.

    Interactions

    Common names:
    Yohimbine
    Botanical names:
    Pausinystalia yohimbe

    Interactions with Supplements, Foods, & Other Compounds

    Foods with high amounts of tyramine (such as cheese, red wine, and liver) should not be eaten while a person is taking yohimbe, as they may theoretically cause severe high blood pressure and other problems. Similarly, yohimbe should only be combined with other antidepressant drugs under the supervision of a physician, though at least one study suggests it may benefit those who are not responding to serotonin reuptake inhibitors such as fluoxetine (Prozac).26

    Interactions with Medicines

    Certain medicines interact with this supplement.

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • none

    Reduce Side Effects

    • none

    Support Medicine

    • Bupropion

      A 50-year-old woman who was unresponsive to traditional antidepressant therapy was reported to have a marked and persistent improvement in mood when yohimbine was added to her bupropion therapy.27 Further research is necessary to determine the significance of this finding.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
    • Fluvoxamine

      The alkaloid yohimbine (Pausinystalia yohimbe) from the African yohimbe tree affects the nervous system in a way that may complement fluvoxamine. One report studied depressed people who had not responded to fluvoxamine. When 5 mg of yohimbine was added three times each day, there was significant improvement. Some people required higher amounts of yohimbine before their depression improved. Because yohimbine can have side effects, it should only be taken under a doctor?s supervision. Yohimbine is a prescription drug, but standardized extracts of yohimbe that contain yohimbine are available as a supplement.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Reduces Effectiveness

    • Brimonidine

      The active ingredients in yohimbine can block the actions of brimonidine in certain human tissues,28 thus reducing the drug?s beneficial effects. Adequate human studies involving the eye are lacking, and until more information is available, yohimbine should be avoided in people using brimonidine.

      The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

    Potential Negative Interaction

    • none

    Explanation Required

    • none

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers? package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

    Side Effects

    Common names:
    Yohimbine
    Botanical names:
    Pausinystalia yohimbe

    Side Effects

    Patients with kidney disease, peptic ulcer or pregnant or breast-feeding women should not use yohimbe.29 Standard amounts may occasionally cause dizziness, nausea, insomnia , anxiety , increased blood pressure , and rapid heart beat,30 though all of these are rare.31 Using more than 40 mg of yohimbine per day can cause dangerous side effects, including loss of muscle function, chills, and vertigo. Some people will also experience hallucinations when taking higher amounts of yohimbine.32 Taking 200 mg yohimbine in one case led to only a brief episode of hypertension, palpitations, and anxiety.33 People with post-traumatic stress disorder34 and panic disorder35 should avoid yohimbe as it may worsen their condition.

    References

    1. Duke J. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 351.

    2. Ernst E, Pittler MH. Yohimbine for erectile dysfunction: A systematic review and meta-analysis of randomized clinical trials. J Urol 1998;159:433?6.

    3. Carey MP, Johnson BT. Effectiveness of yohimbine in the treatment of erectile disorder: Four meta-analytic integrations. Arch Sex Behav 1996;25:341.

    4. Kunelius P, Häkkinen J, Lukkarinen O. Is high-dose yohimbine hydrochloride effective in the treatment of mixed-type impotence? A prospective, randomized, controlled double-blind crossover study. Urol 1997;49:441?4.

    5. Mann K, Klingler T, Noe S, et al. Effect of yohimbine on sexual experiences and nocturnal tumescence and rigidity in erectile dysfunction. Arch Sex Behav 1996;25:1?16.

    6. Mosqueda-Garcia R, Fernandez-Violante R, Tank J, et al. Yohimbine in neurally mediated syncope. Pathophysiological implications. J Clin Invest1998;102:1824?30.

    7. Goldberg MR, Robertson D. Yohimbine: a pharmacological probe for the study of the alpha 2-adrenoceptor.Pharmacol Rev 1983;35:143?80.

    8. Galitzky J, Taouis M, Berlan M, et al. Alpha 2-antagonist compounds and lipid mobilization: evidence for a lipid mobilizing effect of oral yohimbine in healthy male volunteers. Eur J Clin Invest1988;18:587?94.

    9. Zahorska-Markiewicz B, Kucio C, Piskorska D. Adrenergic control of lipolysis and metabolic responses in obesity. Horm Metab Res 1986;18:693?7.

    10. Kucio C, Jonderko K, Piskorska D. Does yohimbine act as a slimming drug? Isr J Med Sci 1991;27:550?6.

    11. Berlin I, Crespo-Laumonnier B, Turpin G, Puech AJ. The alpha-2 adrenoceptor antagonist yohimbine does not facilitate weight loss but blocks adrenaline induced platelet aggregation in obese subjects. Therapie 1989;44:301 [letter].

    12. Sax L. Yohimbine does not affect fat distribution in men. Int J Obes 1991;15:561?5.

    13. Mosqueda-Garcia R, Fernandez-Violante R, Tank J, et al. Yohimbine in neurally mediated syncope. Pathophysiological implications. J Clin Invest 1998;102:1824?30.

    14. Goldberg MR, Robertson D. Yohimbine: a pharmacological probe for the study of the alpha 2-adrenoceptor. Pharmacol Rev 1983;35:143?180

    15. Galitzky J, Taouis M, Berlan M, et al. Alpha 2-antagonist compounds and lipid mobilization: evidence for a lipid mobilizing effect of oral yohimbine in healthy male volunteers. Eur J Clin Invest 1988;18:587?94.

    16. Zahorska-Markiewicz B, Kucio C, Piskorska D. Adrenergic control of lipolysis and metabolic responses in obesity. Horm Metab Res 1986;18:693?7.

    17. Waluga M, Janusz M, Karpel E, et al. Cardiovascular effects of ephedrine, caffeine and yohimbine measured by thoracic electrical bioimpedance in obese women. Clin Physiol 1998;18:69?76.

    18. Sax L. Yohimbine does not affect fat distribution in men. Int J Obes 1991;15:561?5.

    19. Goldberg KA. Yohimbine in the treatment of male erectile sexual dysfunction?a clinical review. Today?s Ther Trends J New Dev Clin Med 1996;14:25?33.

    20. Riley AJ. Yohimbine in the treatment of erectile disorder. Br J Clin Pract 1994;48:133?6.

    21. Ernst E, Pittler MH. Yohimbine for erectile dysfunction: A systematic review and meta-analysis of randomized clinical trials. J Urol 1998;159:433?6.

    22. Carey MP, Johnson BT. Effectiveness of yohimbine in the treatment of erectile disorder: Four meta-analytic integrations. Arch Sex Behav 1996;25:341.

    23. Kunelius P, Häkkinen J, Lukkarinen O. Is high-dose yohimbine hydrochloride effective in the treatment of mixed-type impotence? A prospective, randomized, controlled double-blind crossover study. Urol 1997;49:441?4.

    24. Mann K, Klingler T, Noe S, et al. Effect of yohimbine on sexual experiences and nocturnal tumescence and rigidity in erectile dysfunction. Arch Sex Behav 1996;25:1?16.

    25. Goldberg KA. Yohimbine in the treatment of male erectile sexual dysfunction?a clinical review. Today?s Ther Trends J New Dev Clin Med 1996;14:25?33.

    26. Cappiello A, McDougle CJ, Maleson RT, et al. Yohimbine augmentation of fluvoxamine in refractory depression: A single-blind study. Biol Psychol 1995;38:765?7.

    27. Pollack MH, Hamerness P. Adjunctive yohimbine for treatment in refractory depression. Biol Psychiatry 1993;33:220?1.

    28. Berlan M, LeVerge R, Galitzky J, LeCorre P. Alpha 2-adrenoceptor antagonist potencies of two hydroxylated metabolites of yohimbine. Br J Pharmacol 1993;108:927?32.

    29. Drug Facts and Comparisons. St. Louis: Facts and Comparisons, 1998, 3659.

    30. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 382?3.

    31. Goldberg KA. Yohimbine in the treatment of male erectile sexual dysfunction?a clinical review. Today?s Ther Trends J New Dev Clin Med 1996;14:25?33.

    32. Drug Facts and Comparisons. St. Louis: Facts and Comparisons, 1998, 3659.

    33. Friesen K, Palatnick W, Tenenbein M. Benign course after massive ingestion of yohimbine. J Emerg Med 1993;11:287?8.

    34. Bremner JD, Innis RB, Ng CK, et al. Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder. Arch Gen Psychiatry 1997;54:246?54.

    35. Charney DS, Woods SW, Goodman WK, Heninger GR. Neurobiological mechanisms of panic anxiety: Biochemical and behavioral correlates of yohimbine-induced panic attacks. Am J Psychiatry 1987;144:1030?6.

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