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Yohimbine
Systematic (IUPAC) name
17α-hydroxy-yohimban-16α-
carboxylic acid methyl ester
Identifiers
CAS number 146-48-5
ATC code G04BE04
PubChem 8969
ChemSpider 8622
Chemical data
Formula C21H26N2O3 
Mol. mass 354.44 g/mol (base)
390.90 g/mol (hydrochloride)
Therapeutic considerations
Pregnancy cat.  ?
Legal status OTC
Routes Oral
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Yohimbine is an alkaloid with stimulant and aphrodisiac effects found naturally in Pausinystalia yohimbe (Yohimbe). It is also found naturally in Rauwolfia serpentina (Indian Snakeroot), along with several other active alkaloids. Yohimbine has been used as both an over-the-counter dietary supplement in herbal extract form and prescription medicine in pure form for the treatment of sexual dysfunction(e.d.). Yohimbine was recently associated as a remedy for type 2 diabetes mellitus in animal and human models carrying polymorphisms of the alpha2A-adrenergic receptor gene (Rosengren et al epublished in Science, November 19, 2009).

Contents

Indications

Sexual

The NIH states that yohimbine hydrochloride is the standardized form of yohimbine that is available as a prescription medicine in the United States, and has been shown in human studies to be effective in the treatment of male impotence.[1]

Yohimbine Hydrochloride, USP – a standardized form of yohimbine – is a prescription medicine that has been used to treat erectile dysfunction.[2] Controlled studies suggest that it is not always an effective treatment for impotence, and evidence of increased sex drive (libido) is anecdotal only.[3]

It cannot be excluded that orally administered yohimbine can have a beneficial effect in some patients with ED. The conflicting results available may be attributed to differences in drug design, patient selection, and definitions of positive response. However, generally, available results of treatment are not impressive.[4]

Yohimbine has been shown to be effective in the reversal of sexual satiety and exhaustion in male rats.[5] Yohimbine has also been shown to increase the volume of ejaculated semen in dogs, with the effect lasting at least five hours after administration.[6] Yohimbine has been shown to be effective in the treatment of orgasmic dysfunction in men.[7]

Other uses

Yohimbine has also been used for the treatment of sexual side effects caused by some antidepressants (SSRIs), female hyposexual disorder, as a blood pressure boosting agent in autonomic failure, xerostomia, and as a probe for noradrenergic activity.

Yohimbine has been used to facilitate recall of traumatic memories in the treatment of posttraumatic stress disorder (PTSD).[8] Use of yohimbine outside therapeutic settings may not be appropriate for persons suffering from PTSD.[9]

According to one study, oral yohimbine supplementation may actuate significant fat loss in athletes.[10] Some internet shops sell expensive formulations of yohimbine for transdermal delivery to effect a local reduction of adipose tissue, although there is no experimental evidence that it is effective. Demand for products of this kind is frequently found in the bodybuilding community.

In veterinary medicine, yohimbine is used to reverse anesthesia from the drug xylazine in small and large animals.

Pharmacology

Yohimbine has high affinity for the α2-adrenergic receptor, moderate affinity for the α1-adrenergic, 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1F, 5-HT2B, and D2 receptors, and weak affinity for the 5-HT1E, 5-HT2A, 5-HT5A, 5-HT7, and D3 receptors.[11][12] It behaves as an antagonist at α1-adrenergic, α2-adrenergic, 5-HT1B, 5-HT1D, 5-HT2A, 5-HT2B, and D2, and as a partial agonist at 5-HT1A.[11][13][14][15] Its intrinsic activities at the other sites listed are unclear/unknown but it is probably mostly antagonistic at them.

Production

Yohimbine is the principal alkaloid of the bark of the West African evergreen Pausinystalia yohimbe (formerly Corynanthe yohimbe), family Rubiaceae (Madder family). There are 31 other yohimbane alkaloids found in Yohimbe. In Africa, yohimbe has traditionally been used as an aphrodisiac.[2] However, it is very important to note that while the terms yohimbine, yohimbine hydrochloride, and yohimbe bark extract are related, they are not interchangeable.[1]

The main active chemical present in yohimbe bark is yohimbine HCl (indole alkaloid), found in the bark of the Pausinystalia yohimbe tree.

However, the levels of yohimbine that are present in yohimbe bark extract are variable and often very low.[1] Therefore, although yohimbe bark has been used traditionally to reduce male erectile dysfunction, there is not enough scientific evidence to form a definitive conclusion in this area.

Adverse effects

Yohimbine has significant side effects, such as anxiety reactions. According to the Mayo Clinic, yohimbine can be dangerous if used in excessive amounts.[16]

Higher doses of oral yohimbine may create numerous side effects, such as rapid heart rate, high blood pressure, overstimulation, insomnia and/or sleeplessness. Some effects in rare cases were panic attacks, hallucinations, headaches, dizziness, and skin flushing.[17]

More serious adverse effects may include seizures and renal failure. Yohimbine should not be consumed by anyone with liver, kidney, heart disease, or a psychological disorder.[17]

The range between an effective dose and a dangerous dose is very narrow; too large of a dosage can be harmful and toxic.[17] This may also lead to precipitation of panic disorder type reactions.

See also

References

  1. ^ a b c http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-yohimbe.html National Institutes of Health
  2. ^ a b http://nccam.nih.gov/health/yohimbe/ National Center for Complementary and Alternative Medicine
  3. ^ Andersson KE (September 2001). "Pharmacology of penile erection". Pharmacological Reviews 53 (3): 417–50. PMID 11546836. http://pharmrev.aspetjournals.org/cgi/pmidlookup?view=long&pmid=11546836. 
  4. ^ Andersson, Karl-Erik; Steers, William D. (1998). "The pharmacological basis of sexual therapeutics". in Morales, Alvaro. Erectile dysfunction: issues in current pharmacotherapy. London: Martin Dunitz. pp. 97–124 [114]. ISBN 978-1-85317-577-0. http://books.google.co.uk/books?id=VXPxffpHiXMC&pg=PA97. 
  5. ^ Fernández-Guasti A, Rodríguez-Manzo G (July 2003). "Pharmacological and physiological aspects of sexual exhaustion in male rats". Scandinavian Journal of Psychology 44 (3): 257–63. doi:10.1111/1467-9450.00343. PMID 12914589. 
  6. ^ Yonezawa A, Yoshizumii M, Ebiko M, Amano T, Kimura Y, Sakurada S (October 2005). "Long-lasting effects of yohimbine on the ejaculatory function in male dogs". Biomedical Research 26 (5): 201–6. doi:10.2220/biomedres.26.201. PMID 16295696. 
  7. ^ Adeniyi AA, Brindley GS, Pryor JP, Ralph DJ (May 2007). "Yohimbine in the treatment of orgasmic dysfunction". Asian Journal of Andrology 9 (3): 403–7. doi:10.1111/J.1745-7262.2007.00276.x. PMID 17486282. 
  8. ^ van der Kolk, Bessel A. (1995). "The Treatment of Post Traumatic Stress Disorder". in Hobfoll, Stevan E.; De Vries, Marten W.. Extreme stress and communities: impact and intervention. Boston: Kluwer Academic Publishers. pp. 421–44. ISBN 978-0-7923-3468-2. http://books.google.com/books?id=sVuMSVEY83UC&pg=PA421. 
  9. ^ Morgan CA, Grillon C, Southwick SM, et al. (February 1995). "Yohimbine facilitated acoustic startle in combat veterans with post-traumatic stress disorder". Psychopharmacology 117 (4): 466–71. doi:10.1007/BF02246220. PMID 7604149. 
  10. ^ Ostojic SM (2006). "Yohimbine: the effects on body composition and exercise performance in soccer players". Research in Sports Medicine 14 (4): 289–99. doi:10.1080/15438620600987106. PMID 17214405. 
  11. ^ a b Millan MJ, Newman-Tancredi A, Audinot V, et al. (February 2000). "Agonist and antagonist actions of yohimbine as compared to fluparoxan at alpha(2)-adrenergic receptors (AR)s, serotonin (5-HT)(1A), 5-HT(1B), 5-HT(1D) and dopamine D(2) and D(3) receptors. Significance for the modulation of frontocortical monoaminergic transmission and depressive states". Synapse 35 (2): 79–95. doi:10.1002/(SICI)1098-2396(200002)35:2<79::AID-SYN1>3.0.CO;2-X. PMID 10611634. 
  12. ^ "PDSP Ki Database". http://pdsp.med.unc.edu/pdsp.php#search. 
  13. ^ Arthur JM, Casañas SJ, Raymond JR (June 1993). "Partial agonist properties of rauwolscine and yohimbine for the inhibition of adenylyl cyclase by recombinant human 5-HT1A receptors". Biochemical Pharmacology 45 (11): 2337–41. PMID 8517875. 
  14. ^ Kaumann AJ (June 1983). "Yohimbine and rauwolscine inhibit 5-hydroxytryptamine-induced contraction of large coronary arteries of calf through blockade of 5 HT2 receptors". Naunyn-Schmiedeberg's Archives of Pharmacology 323 (2): 149–54. PMID 6136920. 
  15. ^ Baxter GS, Murphy OE, Blackburn TP (May 1994). "Further characterization of 5-hydroxytryptamine receptors (putative 5-HT2B) in rat stomach fundus longitudinal muscle". British Journal of Pharmacology 112 (1): 323–31. PMID 8032658. 
  16. ^ http://www.mayoclinic.com/health/herbal-viagra/AN00702 Mayo Clinic
  17. ^ a b c Prescription for Nutritional Healing, fourth edition Phyllis A. Balch, CNC

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