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herb

Coryanthe johimbe (Yohimbe)

botanicals

definition

botanical name(s): Coryanthe johimbe, Pausinystalia yohimbe

synonyms: yohimbe

part(s) used: bark

qualities:

affinities:

actions:

dosage:

therapy:

toxicity: 3

» contraindicated in patients with diabetes, hypoglycemia (Duke, p. 351)

» contraindicated in schizophrenia since psychotic episodes can be induced (Tyler et al, Holmberg and Gershow)

» contraindicated in bipolar depression since yohimbine may elicit manic-like symptoms or suicidal tendencies (Holmberg and Gershow, DeSmet and Smeets)

» anxiety can be exacerbated and high blood pressure increased due to its major active alkaloid, yohimbine (Holmberg and Gershow, DeSmet and Smeets, Ingram)

» contraindicated in allergic hypersensitivity to yohimbe due to possible development of dermititis, acute renal failure, and lupus-like syndrome (Sandler and Aronson)

» contraindicated in liver disease or kidney disease (Spoerke, p. 184) due to antidiuresis and the normally rapid metabolism and elimination of its potent alkaloid yohimbine (Brinker, Riley)

» contraindicated in pregnancy or prolonged use due to a lack of teratology and long-term toxicological and carcinogenicity studies of its potent alkaloids (Riley)

» caution: patients taking Coryanthe yohimbe should avoid drugs/products containing phenylpropanolamine and tyramine-containing foods such as liver, cheese, and red wines (Duke, p. 351)

» side-effects of ingestion include: lethargy, restlessness, chills, shivers, nausea, and vertigo

» toxic effects include bradycardia, an increased depth and rate of respiration, and peripheral vasodilation; ultimately it may lead to respiratory paralysis (Glasby, Vol. II, p. 1418; Henry, p. 500)

constituents:

drug interactions:

» hypertension may occur with yohimbine when combined with tricyclic antidepressants such as imipramine (Holmberg and Gershow, DeSmet and Smeets)

» toxicity of yohimbine due to its alpha-2 adrenoceptor antagonism is increased by phenothiazines (DeSmet and Smeets) such as chlorpromazine (Ingram)

» reversal of hypotensive effects of clonidine and similar antihypertensives may result from yohimbine's alpha-2 adrenergic antagonism (DeSmet and Smeets)

» anxiety induced by yohimbine was blocked by reserpine (Ingram)

» hypertension induced by yohimbine was reduced by reserpine, atropine, and amobarbital (Ingram)

footnotes

general references: Goodman and Gilman; U.S. Dispensatory

Brinker F. 1996. The Toxicology of Botanical Medicines, rev. 2nd ed., Sandy, Oregon: Eclectic Medical Publications.

DeSmet PAGM, Smeets OSNM. 1994. Potential risks of health food products containing yohimbe extracts. Br. Med. J, 309:958.

Duke, J.A. 1985. C.R.C. Handbook of Medicinal Herbs. Boca Raton, FL: The C.R.C. Press.

Glasby, J.S. 1975. Encyclopedia of Alkaloids. New York: Plenum Press.

Holmberg G, Gershow S. 1961. Autonomic and Psychic Effects of Yohimbine Hydrochloride. Psychopharm., 2:93-106.

Ingram CG. 1962. Some pharmacologic actions of yohimbine and chlorpromazine in man. Clin. Pharmacol. Therap., 3:345-52.

Riley AJ. 1994. Yohimbine in the treatment of erectile disorder. Br. J Clin. Pract., 48:133-6.

Sandler B, Aronson P. 1993. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urology, 41:343-5.

Spoerke Jr., D.G. 1980. Herbal Medications. Santa Barbara, CA: Woodbridge Press Publishing Company.

Tyler, V.E., Brady, L.R., Robbers, J.E. 1988. Pharmacognosy. 9th ed. Philadelphia: Lea and Febiger.