Yohimbe's therapeutic uses
Yohimbe, derived from the bark of the West African Yohimbe tree, is traditionally recognized for its aphrodisiac properties and is primarily used to treat impotence. The active compound yohimbine, which is available as a prescription medication, has shown modest efficacy in addressing erectile dysfunction, with success rates ranging from 30 to 45 percent. Besides impotence, yohimbe is also suggested for various other conditions, including sexual dysfunction in women, athletic performance enhancement, anxiety, depression, dry mouth, hypotension, and diabetic neuropathy, although scientific evidence supporting many of these uses remains insufficient.
It is important to note that yohimbine's safety profile raises concerns, particularly regarding variability in ingredient concentration in herbal products, which can lead to adverse effects. Common side effects include dizziness, anxiety, and gastrointestinal issues, and higher doses can pose significant risks, such as severe drops in blood pressure and hallucinations. Due to these safety issues, yohimbe should be used only under the supervision of a physician, especially for individuals with pre-existing health conditions or those on specific medications. Overall, while yohimbe has a historical significance in herbal medicine, caution is advised regarding its use and potential side effects.
Yohimbe's therapeutic uses
DEFINITION: Natural plant product used to treat specific health conditions.
PRINCIPAL PROPOSED USE: Impotence
OTHER PROPOSED USE: Sexual dysfunction in women, athletic performance, anxiety, depression, dry mouth, hypotension, diabetic neuropathy
Overview
The bark of the West African Yohimbe tree is a traditional aphrodisiac and the source of yohimbine, a prescription drug for impotence. It appears to be modestly effective, but it also presents numerous safety risks. Yohimbe should not be used except under physician supervision.
Therapeutic Dosages
Yohimbe bark is best taken in a form standardized to yohimbine content, so people can properly control their dose of the drug. Label claims for yohimbine content have been frequently found to be inaccurate. The usual dose of yohimbine is 15 to 30 milligrams (mg) daily. However, higher doses are not necessarily better, and it appears that some people respond optimally to 10 or even 5 mg daily. Furthermore, although some people appear to respond immediately to a single dose, for others, it takes two to three weeks of treatment to provide significant benefits.
Therapeutic Uses
Like the drug yohimbine, the bark of the Yohimbe tree is used to treat impotence, but other drugs on the market in the twenty-first century have overshadowed it. Many herbalists report that the herb is more effective than the purified drug, perhaps because of the presence of other unidentified active ingredients. However, there have been no studies to evaluate this claim. Furthermore, due to the lack of supervision of herbal products, there are real concerns that herbal yohimbe might contain either too much or too little yohimbine.
Yohimbine (the drug) is only modestly effective at best: better than placebo, but successful only in about 30 to 45 percent of the men who use it. Yohimbine has also been evaluated in combination with the supplement arginine. A double-blind, placebo-controlled trial of forty-five men found that one-time use of this combination therapy an hour or two before intercourse improved erectile function, especially in those with only moderate erectile dysfunction scores. Arginine and yohimbine were both taken at a dose of 6 grams.
One small, double-blind study of yohimbine combined with arginine found an increase in measured physical arousal among twenty-three women with female sexual arousal disorder. However, the women themselves did not report any noticeable subjective effects. In addition, only the combination of yohimbine and arginine produced results; neither substance was effective when taken on its own.
An open trial of yohimbine alone to treat sexual dysfunction induced by the antidepressant fluoxetine (Prozac) found improvement in eight out of nine people, two of whom were women. However, in the absence of a placebo group, these results cannot be considered reliable; in addition, there are concerns about the safety of combining Yohimbe with antidepressants.
Yohimbe is also sometimes recommended for depression. However, its effectiveness is unknown, and there are much safer herbs for this purpose, such as St. John’s wort. There are several other suggested therapeutic uses for Yohimbe. Yohimbe may improve athletic performance and promote fat loss because it increases adrenaline. However, more study is needed. Other suggested uses of Yohimbe have included treating anxiety, dry mouth, hypotension, and diabetic neuropathy. Still, there is insufficient scientific evidence to support these claims. The seriousness of the side effects associated with Yohimbe makes double-blind, placebo-controlled studies challenging.
Safety Issues
The following discussion applies to the drug yohimbine rather than the herb yohimbe. All risks of the drug apply to the herb, and there are additional risks to consider. For example, the amount of yohimbine in a given sample of the herb may not be accurately reflected on the label. Furthermore, additional constituents contained in the herb besides yohimbine might present unique and unknown risks of their own.
Yohimbine in any form should not be used by pregnant or nursing women, or those with kidney, liver, or ulcer disease, or high blood pressure. Intake of more than forty mg a day of yohimbine can cause a severe drop in blood pressure, abdominal pain, fatigue, hallucinations, and paralysis. (Interestingly, lower dosages can cause an increase in blood pressure.) Since 40 mg is not very far above the typical recommended dose, yohimbine has what is known as a “narrow therapeutic index.” This means that there is a relatively small dosing range, below which the herb does not work and above which it is toxic.
Even when taken in normal dosages, side effects of dizziness, anxiety, hyperstimulation, and nausea are common. Finally, yohimbine may interact adversely with numerous medications, including tricyclic antidepressants, bupropion, methamphetamine, phenothiazines, clonidine, and other drugs for lowering blood pressure.
Important Interactions
People who are taking tricyclic antidepressants, bupropion, phenothiazines, clonidine, other drugs for lowering blood pressure, and amphetamines, or any other central nervous system stimulants should not use yohimbine.
Bibliography
Fletcher, Jenna. "Yohimbe: Uses and Risks." Medical News Today, 6 Mar. 2020, www.medicalnewstoday.com/articles/yohimbe. Accessed 12 Sept. 2024.
Lebret, T., et al. "Efficacy and Safety of a Novel Combination of L-arginine Glutamate and Yohimbine Hydrochloride: A New Oral Therapy for Erectile Dysfunction." European Urology, vol. 41, 2002, pp. 608-613.
"Yohimbe." Drugs, 26 June 2024, www.drugs.com/npp/yohimbe.html. Accessed 12 Sept. 2024.
"Yohimbine - LiverTox." NCBI, 5 Apr. 2020, www.ncbi.nlm.nih.gov/books/NBK548703. Accessed 12 Sept. 2024.
"Yohimbe: Usefulness and Safety." National Center for Complementary and Integrative Health, Nov. 2020, www.nccih.nih.gov/health/yohimbe. Accessed 12 Sept. 2024.