Pausinystalia yohimbe
Synonyms
No documentation.
Vernacular Name
Johimbe, Yohimbe, Corynanthe yohimbe.
Description
Reaching a height of 30m, the heavily fissured bark of Pausinystalia yohimbe tree is grey-brown in colour and often spotted with lichen. The interior sides of the fissures are typically redder than the outer bark. The erect stems branched heavily with ovate or elliptical leaves, roughly 10cm in length. The winged seeds are delicate and paper thin.
Origin / Habitat
P. yohimbe is an evergreen tree native to South and Central Africa, commonly found in the forests and jungles of Cameroon, Congo, West Africa and Gabon.
Chemical Constituents
The main chemical constituent is Yohimbine, and its stereoisomers alpha-yohimbine, beta-yohimbine, allo-yohimbine. Other constituents include ajamalicine, dihydroyohimbine, corynantheine, dihydrocorynantheine, corynanthine, and tannins[1][2][3].
Plant Part Used
Traditional Use
P. yohimbe is well known both in various traditional medical practices and in present dietary supplement industries for its effect on the reproductive system. The traditional use of this herb in the southern parts of Africa is as a treatment for erectile dysfunction and as an aphrodisiac for members of both sexes. Primarily, a decoction was used to both restore erectile function, and to diminish mental and physical fatigue. In addition to the uses noted above, the bark of P. yohimbe has traditionally been used by African medical practitioners as a tonic to reduce exhaustion much like ginseng would be used by Native Americans. P. yohimbe was also used to reduce discomfort associated with cardiovascular issues simply to ease the chest pain. In related uses, it was used to treat high blood pressure. In addition to the internal uses listed here, P. yohimbe was also used to treat minor skin disorders that would involve some type of inflammation. The topical applications were typically in the form of a paste or ‘plaster’ [4][5].
Pharmacology
Pre-clinical
P. yohimbe bark is used in many countries 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 P. 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 [6]. 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 [7]. 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 [8].
Studies report that yohimbine is able to increase saliva in animals [9].
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 [10]. 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 [11].
Due to its ability to increase saliva, yohimbine has been used for the treatment of dry mouth caused by medications, such as antidepressants [12][13].
A study also found that yohimbine supplementation in professional athletes significantly decreased the body fat percentage [14]. 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 documentation.
Interaction with Drugs
Based on human study, yohimbine has been reported to block the effects of alpha-adrenergic drugs, including clonidine (Catapres) and guanabenz (Wytensin) [6]. 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, in small doses, has been shown to increase blood pressure, specifically in hypertensive patients, and is therefore not recommended for those suffering from hypertension [15].
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 P. yohimbe bark extract to elicit drug interactions. Use P. yohimbe or yohimbine only under a doctor’s supervision if you are taking any prescription or non-prescription medication.
Pregnancy
Not to be used by pregnant or nursing women or by children.
Age limitation
Not to be used by pregnant or nursing women or by children.
Adverse reaction
No documentation.
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References
- Betz JM, White KD, der Marderosian AH. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Int. Sep-Oct. 1995;78(5):1189-1194.
- Zanolari B., Powers MB, Ndjoko K, Loset JR, Marston A, Hostettmann K. Qualitative and quantitative determination of yohimbine in authentic yohimbe bark and in commercial aphrodisiacs by HPLC-UV-API/ MS methods. Phytochem Anal. Jul-Aug. 2003;14(4):193-201.
- Chen Q, Li P, Zhang Z, Li K, Liu J, Li Q. Analysis of yohimbine alkaloid from Pausinystalia yohimbe by non-aqueous capillary electrophoresis and gas chromatography-mass spectrometry. J Sep Sci. Jul. 2008;31(12):2211-2218.
- Neuwinger HD. African Traditional Medicine: A Dictionary of Plant Use and Applications. Stuttgart, Germany: Medpharm Gmbh Scientific Publishers; 2000.
- Schmeltzer GH, Gurib-Fakim A, AGROOH. Medicinal Plants 1. Wageningen, Netherlands: Plant Resources of Tropical Africa; 2008.
- Riley AJ. Yohimbine in the treatment of erectile disorder. Br J Clin Pract. May-Jun. 1994;48(3):133-136.
- 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. 17 Sep 2009. [Epub ahead of print]
- 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 D(2) and D(3) receptors. Significance for the modulation of frontocortical monoaminergic transmission and depressive states. Synapse. 2000;35(2):79-95.
- 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.
- 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.
- Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry. Jun 1992;53(6):207-209.
- Balon R. Fluoxetine-induced sexual dysfunction and yohimbine. J Clin Psychiatry 1993;54(4):161-162.
- 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. Dec. 1992;34(6):555-558.
- Ostojic SM. Yohimbine: the effects on body composition and exercise performance in soccer players. Res Sports Med. 2006;14(4):289-299.
- Grossman E, Rosenthal T, Peleg E, Holmes C, Goldstein DS. Oral yohimbine increases blood pressure and sympathetic nervous outflow in hypertensive patients. J Cardiovasc Pharmacol. Jul. 1993;22(1):22-26.
- Papeschi R. An investigation on the behavioral and hypothermic effects of yohimbine: interaction with drugs affecting central and peripheral monoamines. Arch Int Pharmacodyn Ther. Mar. 1974;208(1):61-80.
- 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. Oct. 2009;77(10):585-590.
- Senbel AM, Mostafa T. Yohimbine enhances the effect of sildenafil on erectile process in rats.Int J Impot Res. Jul-Aug. 2008;20(4):409-417.
- Polanco MJ, Alguacil LF, Albella B. Yohimbine prevents the effect of morphine on the redox status of neuroblastomaxglioma NG108-15 cells. Toxicol Lett. 10 Sep 2009;189(2):115-120.
