Pausinystalia yohimbe

 

Pausinystalia yohimbe

Synonyms

No documentation

Vernacular Name

Johimbi,yohimbehe

Description

The evergreen tree of Pausinystalia yohimbe is found in western Africa. P. yohimbe is used traditionally as an aphrodisiac and is the source of yohimbine hydrochloride which is prescribed for erectile dysfunction.

Reaching a height of 30m, the heavily fissured bark is grey-brown in color and often spotted with lichen.  The interior sides of the fissures are typically redder than the outer bark.  The erect stems branch heavily with ovate or elliptical leaves, roughly 10cm in length.  The winged seeds are delicate and paper thin.

Origin / Habitat

P. yohimbe originates from Africa, specifically Western Africa such as Cameroon and Nigeria, where it has been used for hundreds of years by the Bantu people.  This evergreen needs partial shade and a tropical, warm humid climate to grow.  The roots of P. yohimbe grow deeply in the dry, hard soil, making it hard to extract.

Chemical Constituents

Up to 6% total alkaloids, 5-15% of which is yohimbine. [1],[2]

Plant Part Used

Bark

Medicinal Uses

General

Sexual health/aphrodisiac

Low blood pressure (hypotension)

Weight loss

Most Frequently Reported Uses

Sexual health/aphrodisiac

Dosage

Dosage Range

Dried bark: 250-500mg, ½ capsule 2-3 hours before intimacy.

Yohimbine: Normal doses of the alkaloid yohimbine are 15-42mg daily in 3 divided doses. (Example: 5.4-10mg, 3 times daily for men with erectile dysfunction). DO NOT EXCEED daily dose of yohimbine alkaloids. Length of therapy should not exceed 10 weeks. P. yohimbe and yohimbine are not recommended for use in children.

Supplements should contain no more than the total recommended daily dose of yohimbine, which is 42mg/day. Make sure yohimbe bark supplements are assayed for yohimbine alkaloids.

Most Common Dosage

Dried bark: 350mg per day

Standardized extract: The most common dosage is 30mg per day of yohimbine.

Standardization Dosage

15-42mg of alkaloids (yohimbine) daily

Pharmacology

Pre-clinical

P. yohimbe bark is used as an over-the-counter (OTC) agent for sexual dysfunction. The main alkaloid found in P. yohimbe, yohimbine, is used as a prescription medication for sexual health. As stated earlier, P. yohimbe bark extract may not contain significant amounts of the alkaloid yohimbine, and therefore may not have the same effects on the body or the same potential for side effects and drug interactions. Since there is limited research on yohimbe bark extract, this section on pharmacology will summarize the use of the isolated alkaloid yohimbine.

The mechanism of action of yohimbine includes antagonism of alpha 2-adrenoceptors.[3] Yohimbine causes vasodilatation by activating the nitrergic-soluble guanylate cyclase (NO-sGc) pathway and K(ATP), thereby increasing blood flow to the penis and also potentially lowering blood pressure.[4] Yohimbine has high affinity for the a2A-adrenergic, a2B-adrenergic and a2C-adrenergic receptors and moderate affinity for the 5-HT51A, 5-HT51B 5-HT51C 5-HT51AD 5-HT52B and D2, and weak affinity for the D3 receptor.[5]

Studies report that yohimbine is able to increase saliva in animals.[6]

Clinical

A 1998 systematic review and meta-analysis of randomized clinical trials of yohimbine for erectile dysfunction found that it could be considered an initial pharmacologic agent to use.[7] The authors found that yohimbine is superior to placebo in the treatment of erectile dysfunction with infrequent and reversible adverse reactions. There is also limited research in humans that yohimbine has may be used to treat sexual dysfunction caused by selective serotonin reuptake inhibitor (SSRI) antidepressants.[8]

Due to its ability to increase saliva, yohimbine has been used for the treatment of dry mouth caused by medications, such as antidepressants.[9],[10]

A study also found that yohimbine supplementation in professional athletes significantly decreased the body fat percentage.[11] The authors reported that no individuals reported any side effects from yohimbine. The yohimbine combined with resistance training did not significantly alter the body mass, muscle mass, or performance indicators.

Interaction and Depletions

Interaction with other Herbs

No documention

Interaction with Drugs

The multiple drug interactions may occur with the use of yohimbine hydrochloride. In theory, these effects may also apply to P. yohimbe bark extract, which contains the alkaloid yohimbine. However, there may not be a sufficient quantity of yohimbine contained in the P. yohimbe bark extract to elicit drug interactions. Use P. yohimbe or yohimbine only under a doctors supervision if you are taking any prescription or non-prescription medication.

Based on human study, yohimbine has been reported to block the effects of alpha-adrenergic drugs, including clonidine (Catapres) and guanabenz (Wytensin).[15] Use only under a doctor’s supervision when taking these medications and P. yohimbe.

Based on pharmacology, do not use P. yohimbe in individuals taking antihypertensive medications.

Based on pharmacology, use of P. yohimbe with central nervous system stimulants, such as amphetamines, may have additive effects.

Based on pharmacology, use of P. yohimbe with MAO inhibitors such as isocarboxazid (Marplan®), phenelzine (Nardil®), tranylcypromine (Parnate®) or linezolid (Zyvox®) may produce additive side effects, such as an increased risk of high blood pressure.[16]

Based on pharmacology, use with caution in individuals taking medications to lower blood sugar levels, including insulin.

Based on human study, use of ethanol (alcohol) with yohimbine may produce an additive effect of increasing intoxication and drug seeking behavior.[17]

Based on pharmacology, use with caution when taking medications for erectile dysfunction, including Viagra (sildenafil), as P. yohimbe may potentiate the effects of these drugs.[18]

Based on human study, yohimbine may increase pain relief from morphine.[19] Use with caution if taking opiates for pain control.

Precautions and Contraindications

Side effects

P. yohimbe supplements should be avoided by individuals with pre-existing medical conditions such as high or low blood pressure, diabetes, heart, liver or kidney disease. Discontinue if allergy occurs.

P. yohimbe supplements should only be used under medical supervision in those taking prescription and non-prescription medications.

Pregnancy

P. yohimbe supplements should be avoided during pregnancy as it may relax the uterus and may be toxic to the fetus. P. yohimbe supplements should be avoided during breastfeeding.[12]

Age limitation

No documention

Adverse reaction

P. yohimbe is not generally recommended as a dietary supplement due to a very narrow therapeutic index, leading to an increase in drug interactions and the potential for adverse effects and over dosage. Symptoms of over dosage include excessive adrenal or sympathetic nerve stimulation, anxiety, panic attacks, high blood pressure, increased heart rate, irritability, headache, nausea, skin flushing, sweating, dizziness, frequent urination, water retention, rise in body temperature, and hyperactivity, weakness, paralysis, gastrointestinal problems, hallucinations, psychosis and even death.[13],[14]

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  1) South Africa Herbs

References

  1. Betz JM, White KD, der Marderosian AH. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Int. Sep-Oct1995;78(5):1189-1194.
  2. Chen Q, Li P, Zhang Z. Analysis of yohimbine alkaloid from Pausinystalia yohimbe by non-aqueous capillary electrophoresis and gas chromatography-mass spectrometry. J Sep Sci. Jul2008;31(12):2211-2218.
  3. Riley AJ. Yohimbine in the treatment of erectile disorder. Br J Clin Pract. May-Jun1994;48(3):133-136.
  4. Freitas FC, Nascimento NR, Cerqueira JB. Yohimbine relaxes the human corpus cavernosum through a non-adrenergic mechanism involving the activation of K+ATP-dependent channels. Int J Impot Res. 17Sep2009. [Epub ahead of print]
  5. Millan MJ, Newman-Tancredi A, Audinot V, et al. 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 D2 and D3 receptors. Significance for the modulation of frontocortical monoaminergic transmission and depressive states. Synapse. 2000;35(2):79-95.
  6. Bagheri H, Schmitt L, Berlan M, Montastruc JL. A comparative study of the effects of yohimbine and anetholtrithione on salivary secretion in depressed patients treated with psychotropic drugs. Eur J Clin Pharmacol. 1997;52(5):339-342.
  7. Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta- analysis of randomized clinical trials. J Urol. 1998;159(2):433-436.
  8. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry. Jun1992;53(6):207-209.
  9. Balon R. Fluoxetine-induced sexual dysfunction and yohimbine. J Clin Psychiatry.1993;54(4):161-162.
  10. Bagheri H, Schmitt L, Berlan M, Montastruc JL. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol. Dec1992;34(6):555-558.
  11. Ostojic SM. Yohimbine: the effects on body composition and exercise performance in soccer players. Res Sports Med. 2006;14(4):289-299.
  12. Owen JA, Nakatsu SL, Fenemore J, et al. The pharmacokinetics of yohimbine in man. Eur J Clin Pharmacol 1987;3:877-882.
  13. Giampreti A, Lonati D, Locatelli C. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol (Phila). Sep2009;47(8):827-829.
  14. De Smet PA, Smeets OS. Potential risks of health food products containing yohimbe extracts. BMJ.8 Oct1994;309(6959):958.
  15. Riley AJ. Yohimbine in the treatment of erectile disorder. Br J Clin Pract. May-Jun1994;48(3):133-136.
  16. Papeschi R. An investigation on the behavioral and hypothermic effects of yohimbine: interaction with drugs affecting central and peripheral monoamines. Arch Int Pharmacodyn Ther. Mar1974;208(1):61-80.
  17. Scherr M, Schwerthoeffer D, Froboese T [Psychiatric effects and side effects of the alpha-2-antagonist yohimbine: a review of literature and case report] Fortschr Neurol Psychiatr. Oct2009;77(10):585-590.
  18. Senbel AM, Mostafa T. Yohimbine enhances the effect of sildenafil on erectile process in rats.Int J Impot Res. Jul-Aug2008;20(4):409-417.
  19. Polanco MJ, Alguacil LF, Albella B. Yohimbine prevents the effect of morphine on the redox status of neuroblastomaxglioma NG108-15 cells. Toxicol Lett. 10Sep2009;189(2):115-120.