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.
Is it Effective?
Effectiveness is 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:
Possibly Effective for...
Erectile dysfunction (ED):
There is evidence that the active ingredient, yohimbine, 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.
Sexual problems caused by selective-serotonin reuptake inhibitors (SSRIs). There is evidence from many
studies that the active ingredient, yohimbine, 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.
Insufficient Evidence to Rate Effectiveness for...
Sexual excitement:
Exhaustion:
Chest pain:
Diabetic complications:
Depression:
Other conditions:
More evidence is needed to rate yohimbe for these uses.
How does it work?
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?
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. Dont take yohimbe if you are pregnant or breastfeeding.
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): Dont use yohimbe. There is a report that four individuals with PTSD
suffered worse symptoms after using yohimbe.
Liver disease: Dont use yohimbe. Liver disease might change the way the body processes yohimbe.
Kidney disease: Dont use yohimbe. There is a concern that yohimbine might slow or stop the flow of urine.
High blood pressure or low blood pressure: Dont use yohimbe. Small amounts of yohimbine can increase
blood pressure. Large amounts can cause dangerously low pressure.
Chest pain or heart disease: Dont use yohimbe. Yohimbine can seriously harm the heart.
Anxiety: Dont use yohimbe. Yohimbine might make anxiety worse.
Depression: Dont use yohimbe. Yohimbine might bring out manic-like symptoms in people with bipolar
depression or suicidal tendencies in individuals with depression.
Diabetes: Dont use yohimbe. Yohimbe might interfere with insulin and other medications used for diabetes
and cause low blood sugar.
Are there any interactions with medications?
Clonidine (Catapres)
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.
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)
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.

Yohimbe contains a chemical called yohimbine. Yohimbine can decrease the effectiveness of guanabenz
(Wytensin).
Medications for depression (MAOIs)
Interaction Rating = Major Do not take this combination.
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.
Medications for depression (Tricyclic antidepressants)
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.
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)
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.
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.
Naloxone (Narcan)
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.
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
Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.
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

Interaction Rating = Moderate Be cautious with this combination.

Talk with your health provider.
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 any interactions with Herbs and Supplements?
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.
Are there interactions with Foods?
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?
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.
What other names is the product known by?
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.

References
Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food,
Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products
Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of HealthSystem Pharmacists, 1998.
Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ:
Medical Economics Company, Inc., 1998.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic
Medical Publications, 1998.
Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and
Comparisons, St. Louis, MO.
Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal
Press, 1999.
Southwick SM, Morgan CA III, Charney DS, High JR. Yohimbine use in a natural
setting: effects on post-traumatic stress disorder. Biol Psychiatr 1999;46:442-4.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=10435213&dopt=Abstract
Owen JA, Nakatsu SL, Fenemore J, et al. The pharmacokinetics of yohimbine in man.

Eur J Clin Pharmacol 1987;3:877-82.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=3653227&dopt=Abstract
Cappiello A, McDougle CJ, Malison RT, et al. Yohimbine augmentation of Fluvoxamine
in refactory depression: a single blind study. Biol Psychiatry 1995;38:765-7.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=8580232&dopt=Abstract
Montorsi F, Strambi LF, Guazzoni G, et al. Effect of yohimbine-trazodone on
psychogenic impotence: a randomized, double-blind, placebo-controlled study.
Urology 1994;44:732-6.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=7974947&dopt=Abstract
Balon R. Fluoxetine-induced sexual dysfunction and yohimbine. J Clin Psychiatry
1993;54:161-2.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=8836468&dopt=Abstract
Carey MP, Johnson BT. Effectiveness of yohimbine in the treatment of erectile
disorder: four meta-analytic integrations. Arch Sex Behav 1996;25:341-60.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=8836468&dopt=Abstract
Kunellius P, Hakkinen 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.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=9123711&dopt=Abstract
Wagner G, Saenz de Tejada IS. Update on male erectile dysfunction. BMJ
1998;316:678-82.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=9522795&dopt=Abstract
Witt DK. Yohimbine for erectile dysfuntion. J Fam Pract 1998;46:282-3.
Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine
hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4.
Ashton AK. Yohimbine in the treatment of male erectile dysfunction. Am J Psychiatr
1994;151:1397.
Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine.
J Clin Psychiatry 1992;53:119-22.
Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by
serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
Harvey KV, Balon R. Clinical implications of antidepressant drug effects on sexual
function. Ann Clin Psychiatry 1995;7:189-201.
Balon R. The effects of anitdepressants on human sexuality: diagnosis and
management update 1999. Primary Psychiatry 1999;6:40-54.
Chevallier A. The Encyclopedia of Medicinal Plants. London, UK: Dorling Kindersley,
Ltd., 1996.

Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal

failure, and lupus-like syndrome. Urol 1993;41:343-5.
Varnell MA. Enhanced herb may help female sexual dysfunction. Reuters Health
2000;Jun 27. www.reutershealth.com/frame/eline.html (Accessed 28 June 2000).
Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and
meta-analysis of randomized clinical trials. J Urol 1998;159:433-6.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=9649257&dopt=Abstract
Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbinecontaining products: a retrospective review of the California Poison Control System
reported cases. Ann Pharmacother 2010;44:1022-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=20442348&dopt=Abstract