Yohimbe or yohimbine – which is better?
I have long been undecided on what would have the better effect: yohimbe, the bark, or yohimbine, the pharmaceutical.
I am now convinced that yohimbine, the pharmaceutical, is to be recommended over yohimbe, the bark.
The bark contains a good number of alkaloids, of which yohimbine is just one. Other indole alkaloids found in yohimbe bark are the yohimbine stereoisomers “-yohimbine” and allo-yohimbine, as well as ajamalicin, dihydroyohimbine, corynanthein, dihydrocorynanthein, and corynanthin (rauhinbin).
While some of the other alkaloids found in yohimbe bark have been suspected to aid in the bark’s function as aphrodisiac, their pro-sexual effect definitely is not as pronounced as the one of yohimbine. Other effects may be attributed to them.
Traditional uses of yohimbe bark are not limited to its pro-sexual effects. Yohimbe bark has also long been smoked or otherwise ingested to facilitate hallucinogenic experiences. I have tried smoking the bark. It doesn’t burn well, and as I am a non-tobacco smoker, I don’t have much tolerance for inhaling smoke. I smoked a mere quarter of a gram of the bark. It caused a mild nausea nothing pleasurable.
I have read sources on the Internet in which people with a history of “drug abuse” cooked some 7 teaspoons of bark as a tea. The word “tea” suggests that they didn’t ingest the cooked bark but just the water in which they tried to extract the bark.
But yohimbine is difficult to extract by boiling. In the industrial production of yohimbine, hydrochloric acid is used. Stomach acidity is needed to extract the yohimbe from ingested yohimbe powder. Yohimbe tea will not do.
I have tried the ingestion of about 1 teaspoon of finely ground yohimbe bark, simmered in orange juice under addition of about 1 gram Vitamin C. This was not a tea; there was no bark leftover. The ground yohimbe floated in the orange juice.
From this concoction, I had a mental effect that I usually do not feel from ingesting yohimbine tablets or yohimbe extracts. It gave me a headache. The genital effect was lesser.
On the other hand, sleep has been even more difficult after ingesting yohimbe bark instead of yohimbine, the pharmaceutical. From an honest 10 mg of yohimbine, I can have a pronounced pro-sexual effect and usually can find sleep some 20 hours later.
If I ingest raw powdered yohimbe bark in an amount small enough that it doesn’t give me a headache, I have very little pro-sexual benefit but may not be able to sleep for 24 hours or more. If I haven’t ingested the yohimbe bark in the morning right after getting up, this can add up to 36 or more hours without sleep.
For yohimbe bark, the sleep-prohibiting effect sets in at a dosage still too small for a pronounced pro-sexual effect, and it seems that yohimbe alkaloids other than yohimbine are harder to break down by my metabolic system. Therefore, I judge the synthesis of yohimbine as a clear progress.
I assume that the relationship between yohimbe bark and yohimbine is similar to the relationship between raw opium and morphine or heroin. I have never consumed heroin but have once been on morphine (for a tonsils operation), and I have once (in India) smoked opium. I have also talked to a number of addicts in Europe. They characterized morphine and heroin as much “cleaner” in its effect than opium. Smoking opium largely immobilizes, and opium smokers are drowsed. Those who do morphine or heroin usually are not. I get an idea when they characterize opium as “dirty” drug. It affects all kinds of bodily functions while morphine and heroin are said to just give a persistent orgasmic pleasure. (This is obviously no endorsement of morphine or heroin; one pays too dearly for a kick a few times.)
I have considerable experience with yohimbe bark, yohimbe extracts, and pure yohimbine. I, too, would describe yohimbine, the pharmaceutical, as “cleaner” in effect than yohimbe, the bark. Yohimbine is more concentrated on sexual effects, and it doesn’t give me a headache, or make me feel dumb. Not at all; rather it promotes mental alertness.
Obviously, yohimbe is more readily available in most countries than is yohimbine. In the US, yohimbe bark is sold in health food stores while yohimbine is a prescription drug. That’s a disadvantage to US consumers.
It’s a disadvantage not only because the effects of yohimbine are more specifically pro-sexual than the effects of the alkaloid mixture of the bark. It’s a disadvantage also because it is almost impossible to give proper dosage recommendations for the bark. If you use bark or bark extracts, you will always have to try, and often not have the desired effect because the dosage is too small; but you can’t start with a generous dosage either because you may accidentally just have a good specimen.
Even genuine yohimbe bark varies greatly in its content of yohimbine. It could be 1 percent, but it could also be considerably more or less. How much yohimbine is found in yohimbe bark depends, for example, on what time of the year it is harvested. Exposure to more rain is believed to increase the yohimbine content of yohimbe bark. Exposure to sunlight (after harvesting) is considered to have a negative effect on the yohimbine concentration.
Another problem is that what is sold as yohimbe bark is not always the bark of the Pausinystalia yohimbe (Corynanthe yohimbe) tree but also of the more common Pausinystalia macroceras tree. Even experts have a hard time to keep the two apart, and in West Africa, Pausinystalia macroceras bark is used as a substitute for Pausinystalia yohimbe bark in areas where the latter has become extinct due to over-exploitation. However, Pausinystalia macroceras bark is much lower in yohimbine content; instead it boosts a higher content of the related but largely ineffective alkaloid yohimbinine.
Sure, some yohimbe extract capsules may have a good yohimbine content. Luckily, the first ones I myself have tried were very effective on me. And I have never found a bark extract of similar strength. Many commercial products I tried later were largely ineffective.
Technical Resources International, Inc. reported: “Betz and coworkers (1995) investigated yohimbine in commercial yohimbe products. Gas chromatograph determinations were done on liquids and powders (from capsules and caplets). Virtually all the products tested did not specify on their labels that the product contained yohimbe bark extract. Concentrations of yohimbine in the commercial products ranged from >0.1 to 489 ppm, compared with 7089 ppm in the authentic bark material. Of the 26 products examined, nine contained no quantifiable amount of yohimbine; eight contained only trace amounts (0.1-1 ppm). The authors suggest that the absence of alkaloids in the products indicated that the original extraction was aqueous (because the alkaloids are not particularly water soluble), the extract was extremely diluted in the final dosage form, or no yohimbe bark was used to make the product.”
With yohimbe and yohimbe extracts, one never knows. Most yohimbe products are weak, but occasionally one gets a real strong one on which one can potentially overdose. You can’t go by the labels. The only way to know the strength of the capsules contained in a particular bottle is to try them (or to make a laboratory analysis). When testing a new yohimbe product, I always start with a very low dose, about half a capsule, and then work myself up to several capsules a time, depending on how well a lower dosage worked.
Yohimbe capsules standardized for a certain amount of yohimbine are now emerging on the market. One of the first standardized products was Twinlab’s Yohimbe Fuel for which they claim 8 mg of yohimbine per capsule.
Laboratories sell all kinds of yohimbe extracts, 1:2, 1:4, 1:8, or 1%, 2 %, 4 %. If you see a bottle that claims “Yohimbe Extract”, you don’t know nothing yet. How strong it is may depend on the logics applied by the manufacturer of the specific capsules. Some manufacturers may want to err on the safe side, so they use a weak extract; others may see a market for a brand name of yohimbe extract that actually works. So they may go for a strong extract.
One reason why I recommend yohimbine over yohimbe is that working with yohimbe will waste a lot of time. When you open a bottle, it will take three or four trials until you really can judge the contents. With yohimbine tablets you can be much more certain as to what to expect.
Yohimbine plus Pfizer’s Blue
I was careful trying the combination of yohimbine and sildenafil citrate, but I am glad I did. This is one of the few cases where a combination clearly is superior to either of the drugs alone.
I started combining 5 to 10 milligram yohimbine with 10 to 20 milligram of sildenafil citrate, and the results were surprisingly good; they were definitely better than the results for sildenafil citrate alone.
While a phosphodiesterase inhibitor alone may be a reliable agent in bringing about an erection, even in men who otherwise cannot achieve one, Phosphodiesterase inhibitors have far less mental effect than does yohimbine. If the aim is making good sex better, and not just making intercourse possible, then yohimbine alone has an edge over a phosphodiesterase inhibitor alone.
However, as stated above, I have found the combination of a regular dose of yohimbine with a comparatively small dose of sildenafil citrate a surprisingly pleasant experience. Though for both medications, heart problems are cited as possible side effects, I myself did not experience any complications. The sildenafil citrate just resulted in a very quick and lasting erectile reflex, while the yohimbine provided the usual mental and physical sexual tenseness as a base on which to start with. The effects of sildenafil citrate wore off faster than those of the yohimbine (sildenafil citrate = 6 to 8 hours, yohimbine around 20 hours).
I have tried to increase the sildenafil component in the combination but achieved no better results. When going up to 50 milligram of sildenafil citrate, I actually seem to have weaker orgasms than on some 20 milligram. The 20 milligram of sildenafil citrate in combination with the yohimbine already provide an erection that doesn’t leave much to be desired, so any further attempts could only target orgasm strength. To that end, reducing the sildenafil to some 20 milligram is actually helpful.
On the other hand, further increasing the yohimbine component gives me tachycardia (increased heartbeat), which I’d like to avoid if possible. In the case of combining yohimbine with sildenafil citrate, I was lucky to have found the combination that works best for me right in my first trial.
Please note: Pfizer’s erection pill alone is a disappointment for me; it produces an erection all right, but an erection alone doesn’t result in desire, and without increased desire, intercourse is boring.
I am not a physician. Therefore, my report on my own experience is not intended as medical advice. I myself meanwhile have a good tolerance for yohimbe / yohimbine. Still, in between sildenafil citrate and yohimbine, the latter is more likely to cause unpleasant side effects. Whoever intends to experiment with a combination of sildenafil citrate and yohimbine should start with very low dosages of both medications, just to see how well they are tolerated.
While both yohimbine and sildenafil citrate are prescription medications in the US and some other countries, I am not aware of physicians commonly prescribing the two in tandem. They should. It also doesn’t seem as if Pfizer would have done studies of the two drugs in combination, or that the FDA would have required such studies. Pfizer’s interest is obviously in marketing sildenafil citrate, not in promoting another therapeutic agent, yohimbine.
Yohimbe combined with bromocriptine or deprenyl
I have tried combining yohimbe with deprenyl and/or sildenafil citrate, as well as with arginine, and occasionally with bromocriptine. I tried these combinations over several weeks (though not every day).
Yohimbe plus bromocriptine
Bromocriptine in itself can have an effect on desire. However, with small doses, the effect wears off after just a few uses – and with larger dosages, nausea will eliminate any pro-sexual effect.
While nausea can be avoided when taking bromocriptine in very small dosages alone or with sildenafil citrate, the trick does not work when combining bromocriptine with yohimbe. When on yohimbe, I have never managed to avoid the nausea caused by adding bromocriptine. If nausea occurs when using bromocriptine alone, I can sometimes escape the discomfort by going to sleep. After ingesting bromocriptine with yohimbe I may get to sleep more easily than on yohimbe alone, but sleep quality is nowhere near what it would be without the yohimbe.
I do not recommend combining yohimbe with bromocriptine. And I do not recommend either alone. Both substances mess up sexual quality, and especially bromocriptine does damage to sexual parameters. This is in contrast to tongkat ali which improves long-term sexual health.
Yohimbe plus deprenyl
I have also tried deprenyl (selegeline, Jumex) with yohimbe. Deprenyl is a MAO inhibitor, and I had read that MAO inhibitors don’t go well with yohimbe, so I was careful with the dosages. I had previously tried deprenyl alone, and found it to have an amphetamine-like effect at dosages of more than 2.5 milligrams (half a standard Jumex tablet). I don’t feel the amphetamine-like effect anymore with up to 5 milligrams. But for me, deprenyl also detracts from the yohimbe when combined with it.
I have always found deprenyl’s pro-sexual effects overrated. It’s a dopaminergic substance, and dopamine is, to a certain extent, responsible for sexual desire. But dopamine overstimulation strongly interferes with erectile function and leads to a (reversible) shrinkage of the male organ. That’s why cocaine, and amphetamines may make you horny, but also make erections and orgasms more difficult to achieve.
Deprenyl is not as bad as amphetamine and methamphetamine in making erections more difficult. It may even be that a 25-year-old would not feel any erectile impediment. But for a man of about 50, the anti-erection effect is stronger than the pro-libido effect, unless there is a clear dopamine deficit (as with Parkinson’s patients).
One can counterbalance the anti-erection effect of deprenyl with a phosphodiesterase inhibitor. In fact, I have been told that drug users now regularly mix cocaine with sildenafil citrate to avoid shrinkage.
But why combine yohimbe and deprenyl when this is no better than yohimbe alone, and definitely worse than the combination of yohimbe with sildenafil citrate?
As deprenyl is an MAO inhibitor, it may possibly aggravate the negative side effects of yohimbe. Yohimbine is an alpha-2-receptor blocker; it frees systemic adrenaline and noradrenaline. Adrenaline and noradrenaline (epinephrine and norepinephrine) function as hormones and as neurotransmitters. The adrenaline and noradrenaline displaced by the yohimbe from alpha-2-receptors lead to mental agitation as well as increased heart rate.
This effect is countered by the enzyme monoamine oxidase (MAO), which breaks down adrenaline and noradrenaline, leading to relaxation after states of agitation. MAO inhibitors interfere with monoamine oxidase’s capability to deaminate and destroy adrenaline and noradrenaline. In combination with yohimbe, this means that the agitated state lasts until the yohimbine has cleared from the alpha-2-receptors. With unimpaired monoamine oxidase, the agitation caused by the displacement of adrenaline from alpha-2-receptors should be countered by the breakdown of free adrenaline and noradrenaline.
Combining deprenyl with yohimbe will likely prolong the negative side effects of yohimbe, such as heart palpitation, nervousness, and sleeplessness, while doing little or nothing to enhance the pro-sexual effects.
What we would really like with yohimbe is increased MAO activity, not diminished MAO activity, so we could go to sleep after having enjoyed yohimbe’s pro-sexual effects. Therefore, we don’t want deprenyl, but some sort of ‘anti-deprenyl’ .
Yohimbe and sleep
For me, the worst side effect of yohimbe is that I cannot go to sleep for at least 20 hours after having ingested even just a small amount of the herbal.
This is not the case for all those who try yohimbe. Some people sleep perfectly normal, even after ingesting yohimbe just two or three hours before retiring. It’s the same group of people on whom yohimbe also doesn’t have much of a sexual effect.
However, in those subjects in whom yohimbe (the root) in dosages equivalent of 5 to 20 milligram yohimbine (the active ingredient) has a pronounced pro-sexual effect, the dosage needed for sleep avoidance is considerably less than the one for pro-sexual effects.
If yohimbe is taken daily, the sleep problem typically is worst on the first day.
My own approach is to take yohimbe on one day, and on the next day not to take any, as I really feel that I need yohimbe-undisturbed sleep in the second night.
Another approach (which I think is inferior because it diminishes the pro-sexual effect of yohimbe) is to take it every day for about a week or two, and then to take a few days off. When I followed this approach, I slept a lot on the off-days, up to 12 hours. On the first off-day, it may even have been 16 hours.
By taking yohimbe in cycles of a week or two, I achieve an almost normal sleep pattern after two or three days. In the first night of such a yohimbe cycle, I usually did not sleep at all. When I was lucky, I did get some sleep before noon on the next day. On the second day, I took my daily yohimbe dosage directly after having had a little sleep (as little as two hours). The next night, I got to sleep at 2 or 3 in the morning, and actually slept for five or six hours. On the third day, I would ingest my yohimbe only a few hours after waking up, to have the ingestion time closer to the most likely time for sexual intercourse. Sleep would still be light, but I could be quite sure that I would get some sleep. On following days, I would have an almost normal sleep pattern, so sleep would be light.
The crux with this approach is that I during such a course, the yohimbe loses its pro-sexual power. This of course defeats the logic of any yohimbe regimen.
I have tried everything I could think of in order to force sleep after taking yohimbe when not having ingested any on the previous day. Nothing really works.
The worst has been melatonin. After having ingested yohimbe, melatonin does nothing to get me to sleep. It just makes me feel drowsed until it is cleared from my system.
Kava-kava doesn’t induce sleep after yohimbe. But it does make me feel more relaxed while still being kept awake by the yohimbe.
A tea that contains valerian helps a little bit in falling and staying asleep after yohimbe usage. It doesn’t work all the time, though. But unlike melatonin, it doesn’t make me feel drowsed when it doesn’t induce sleep.
Valium, on the other hand, does make me feel typically valium-drowsed. It may force sleep for an hour or two, but I don’t find the Valium-induced sleep sufficiently regenerative. I prefer not sleeping for 20 hours after yohimbe ingestion over two hours of Valium sleep.
I have tried one herb that on the occasion of trying it did induce sleep. It also reverted the pro-sexual effect of yohimbe, so I do not see much wisdom in pursuing its use. I cannot even recommend it for inducing sleep, if just for the reason that this stuff is outlawed in many countries (but not the Netherlands). I’m talking about marihuana.
I have seen reports that actually promote marihuana as an aphrodisiac. But I have also read reports on alleged pro-sexual capacities on almost every herb, even such strong anti-sexual herbs as saw palmetto or pygeum. It’s usually obvious why claims to pro-sexual activities are made: people want to sell their wares.
In the case of marihuana, those who seek the weed’s legalization increasingly take the route of promoting the benefits of “medical marihuana” the use of marihuana to treat specific conditions, ranging from eye pain to epileptic seizures.
Wouldn’t it be great if marihuana also were of use to treat sexual dysfunction? As a viable alternative to sildenafil citrate, who would dare to prohibit its pharmacological use?
Fewer people would be enticed to support marihuana legalization if its pharmacological use shall be to dampen a patient’s libido. There are already enough dampeners on the market. Unfortunately, marihuana’s effect on sexual function is exactly this: to dampen it, which is not surprising for a sedative.
After marihuana use, a certain dumbness will engulf one’s body, described as being “stoned”. This dumbness also extends to the primary reproductive organ, making its proper use (and the enjoyment to be derived from that) more difficult.
But, as mentioned above: marihuana has some efficacy in putting you to sleep after yohimbe ingestion. (Don’t plan another round of pleasure after your smoke.)
If ever possible, try to use pharmaceutical yohimbine rather than yohimbe bark. It's not just that you can clearly dose with pharmaceutical yohimbine. Yohimbe bark also contains a number of other alkaloids, apart from yohimbine, and these other alkaloids account for some of the possible irritating side effects, such as headache.
Most of what you can buy as yohimbe capsules unfortunately seems to contain many of the other alkaloids but very little yohimbine.
For that reason, if you cannot get hold of pure pharmaceutical yohimbine, at least buy reconstituted yohimbe. A common yohimbe product that has been reconstituted is Twinlab's Yohimbe Fuel.
Each capsule of Yohimbe Fuel contains: Yohimbe Bark Extract 400 mg, with 8 mg of yohimbine, Calcium 40 mg, Phosphorous 32 mg
Please note that it is comparatively easy to reconstitute yohimbe for a standardized amount of yohimbine because it's exact molecular structure is known, and isolating it with reagents is so simple that an industrial process for producing it exists since the 19th century.
There are no industrial processes to isolate active ingredients of tongkat ali, butea superba, and kaempferia parviflora as of yet, and claims for standardization of active ingredients of these plants are all fraudulent.
Review of yohimbe products
In mail this site has received from around the world, readers reported widely different experiences with yohimbe. Some readers mentioned that on standard recommended dosages they almost passed out (or at least felt as if they would) while others reported that they couldn’t feel any effect at all.
Of course, as is the case with any therapeutic agent, yohimbine (the main active ingredient of yohimbe bark) affects different people differently. However, the grave differences among the personal experiences as they were reported are only partially the responsibility of a different yohimbine tolerance level in different people. Rather, different experiences are often just the result of different brands tried.
The point is: because yohimbine, the most active ingredient of yohimbe bark, is by itself a prescription medication, most people in the US use yohimbe bark instead, which is freely available. So, what people normally ingest are not specific amounts of the pharmaceutical agent yohimbine but a certain number of milligrams of yohimbe bark or yohimbe bark extract. Depending on brand and production batch, the yohimbine content may vary between 5 and 0.05 percent. And if the yohimbine content of one brand can be 100 times that of another brand, it is only natural that people report different experiences, depending on the brand they tried.
We would consider 5 milligram of yohimbine a low standard dosage, and 10 mg a more generous standard dosage. US yohimbine prescription dosages are 5.4 milligram per tablet. Yohimbine prescription tablets are available under a good number of brand names, the reason being that yohimbine is not a patented substance. Why the US Food and Drug Administration, in their infinite wisdom, have decided that the dosage that can be sold as prescription medication should be 5.4 milligram and not 5.3 or 5.5, is something ordinary mortals will have some difficulty to understand. But the dice of the FDA decision fell for 5.4, and 5.4 it shall be until the yohimbe tree will become extinct.
Nevertheless, the 5.4-milligram tablets usually have an indented line along which they can easily be split. Recommendations vary between half a tablet an hour before sex and 1 to 2 tablets several times a day. (See the articles on Yohimbe and sleep and on My current own yohimbe regimen for information on what I consider a sensible dosage.)
The effect of about 10 milligram of yohimbine is pretty consistent in a test subject, and it’s usually a good, effective dosage, so we take it as benchmark. We have experience with more yohimbe products than we have listed below. However, we previously haven’t kept record, and those products reviewed below are the ones we have used consistently, or recently.
YOHIMEX is the US yohimbine prescription medication of Kramer Labs. It’s yohimbine and just yohimbine, nothing else… no secret formula or other attempts at cheating. If you can get a yohimbine prescription from your physician, it’s a well-controlled and sufficiently economical method to ensure your yohimbine levels.
SIGMA-ALDRICH sells a number of yohimbe products. However, in the US, they do not sell to everybody, but just to laboratories. I had no problem buying Sigma-Aldrich yohimbine in Southeast Asia, and I have found it well tolerated and effective. And, of course, at about 1 cent a milligram, it’s really cheap.
PROCOMIL is a non-prescription medication sold in a good number of countries where tablets containing yohimbine can be traded over the counter. The German-made coated tablets contain 5 milligram of yohimbine plus a number of other substances, among them 0.1 milligram of methyltestosterone, some muira puama, and traces of desiccated (dried) animal testicles. The effect of Procomil is largely one of yohimbine. Actually, I doubt that the other ingredients have anything to do with the pro-sexual power of Procomil. They are probably just a gimmick aimed to hide the fact that what is sold as active ingredient is just yohimbine. Obviously, creating the aura of a specifically formulated product has its advantages for the company that sells Procomil (the Hamburg, Germany-based Walter Ritter Pharmaceuticals). Consumers may develop a higher level of brand loyalty, and competitors are easier fought off. But for all practical reason, Procomil is yohimbine in a 5-milligram dosage, and if prescription yohimbine is not available in your country, Procomil is a reliable substitute. Procomil is sold in many Arab countries and in Thailand.
AMERIFIT 1500. Among yohimbe bark products we have found AMERIFITS 1500 milligram yohimbe bark to be rather weak. We would have to ingest at least 3 or 4 of the rather large tablets to get the feeling of 5 milligram of yohimbine.
YOHIMBE FUEL from Twinlab has the advantage of being standardized. Allegedly, it is being standardized for 8 mg of yohimbine per capsule, but I feel that it’s milder (or weaker) per capsule than for example Yohimex 5 mg tablets. The maximum I have ingested in one day were 7 capsules (first 4, and 4 hours later another 3). If one capsule indeed contains 8 mg, this added up to 56 mg. I have to say that it was a bit too much. The sexual effect was strong, but I had the worst heart palpitations I ever experienced on yohimbe. I am not sure, though, whether it was the yohimbe alone, or whether my condition was aggravated by some 50 gram of chocolate I ate in the morning. (Anything containing caffeine or theobromine or related substances is strictly counter-indicated with yohimbe.) My usual dosage of Yohimbe Fuel is 2 capsules in the morning. It carries me into the evening (as all yohimbine does), and in combination with sildenafil citrate (some one to two hours before intercourse) I have used it very often.
The reader is reminded, that meanwhile I have more tolerance for yohimbe than I did a few years ago, so while 2 capsules are OK for me, they may be too much for some people. Those who have no experience with yohimbe, or know that they have a low tolerance for yohimbine, should try 1 capsule first. We have run a price comparison for Yohimbe Fuel with many online retailers.
RAW YOHIMBE BARK, as sold in some health-food stores, contains many other alkaloids apart from yohimbine. I find raw bark clearly inferior to bark extracts or pure yohimbine. Raw yohimbe bark actually often gives me a headache and a feeling of mental numbness, while bark extracts that have a high yohimbine content, or even more so pure yohimbine, tend to support mental clarity and alertness. I often write articles after having ingested yohimbine; but after having used yohimbe bark, I’m not much in the mood for writing. The dosages I tried ranged from a quarter teaspoon (too little for a pro-sexual effect) to a full teaspoon (which gave me a headache). When using raw bark, one has to be aware that yohimbine is not easily dissolved in water. Cooking the bark, and drinking the water as tea, may only deliver a small percentage of the yohimbine contained in the bark. If one doesn’t want to ingest milled raw bark, one should cook the bark in an organic acid like vitamin C, or in orange juice.
Is yohimbine a MAO inhibitor?
Are yohimbe and/or yohimbine MAO inhibitors? There seems to be a fair bit of confusion. The confusion is caused by the fact that while yohimbe and yohimbine are not MAO inhibiting in the same manner as drugs used expressively as MAO inhibitors (see list at the end of this article), there indeed seems to be some influence on MAO activity.
Ellen Coleman, RD, MA, MPH, claims on the Health Care Reality Check web site (quoted August 19, 1999):
“Yohimbine is a monoamine oxidase inhibitor which means that tyramine containing foods (red wine, liver, cheese) and nasal decongestants or diet aids containing phenylpropaanolamine should be rigorously avoided if it is used to prevent a hypertensive crisis.”
While the Health Care Reality Check web site is dedicated to the noble task of protecting consumers from quacks who will sell anything as remedy against any condition as long as it earns them a buck, they exaggerated their reporting on yohimbe and yohimbine:
“According to the FDA, documented health hazards include low blood pressure, weakness, and nervous stimulation, followed by paralysis, fatigue, stomach disorders, kidney failure, seizures and death. The FDA has declared yohimbine unsafe and ineffective for over the counter sale.”
This is simply wrong. Yohimbine may not be an over-the-counter medication. But yohimbine is a FDA-approved prescription drug. If it were inappropriate, the FDA approval would be withdrawn. And as far as “documented health hazards” are concerned, well, death, and a variety of diseases leading to it, are documented health hazards for many antibiotics. And like antibiotics, yohimbine is useful in spite of documented health hazards associated with it.
But the topic of this article is yohimbe / yohimbine and MAO inhibition.
Monoamine oxidase (MAO) inhibition is a profound physiological event, definitely not something to be overlooked in the description of any medication. Chairman MAO is an enzyme present in various parts of the body, primarily in the digestive system and the central nervous system. Its function is the deamination of foods and neurotransmitters.
The crucial impact of monoamine oxidase (MAO) inhibitors is related to this parallel occurrence of monoamines in food and catecholamine neurotransmitters such as dopamine, epinephrine (adrenaline), and norepinephrine (noradrenaline). If the action of the MAO enzyme is interrupted, the breakdown of these catecholamine neurotransmitters is hindered. This is wished for in the treatment of Parkinson’s, a disease characterized by a depletion of dopamine.
MAO inhibitors are “dangerous” medications because they not only inhibit the breaking down of monoamine neurotransmitters but also can interfere with the deamination of monoamines in the digestive tract. If then, monoamines make their way past the digestive tract they can start acting in the same manner as neurotransmitters, primarily norepinephrine, on a number of physiological functions, especially blood pressure. A combination of MAO inhibiting drugs with many ordinary foods that contain tyramines is a sure recipe for hypertensive shock and death.
Usually, red wine, chocolate, and cheeses are given as examples of foods containing tyramines, but tyramines can occur in many other foods as well. Also, the tyramine content of foods is difficult to predict. The content of tyramines in many foods tends to increase with storage. In a fresher state, many different kinds of food have a lower (or insignificant) content of tyramines, while after having been stored for some time, the contents of tyramines are higher. There are very long and explicit lists on tyramine contents in specific foods, compiled for patients who have to take MAO inhibitors to control Parkinson’s.
Obviously, the above is not a complete characterization of chairman MAO and MAO inhibitors. For example, we have not discussed the difference between MAO-A and MAO-B, as well as the effects of MAO on behavior (low levels of MAO are associated with criminal behavior as well as with a polygamous lifestyle). Nevertheless, the above may already give the reader an idea why it is very unlikely that with a prescription medication such as yohimbine, there wouldn’t be an explicit warning if it were a MAO inhibitor.
Yohimex is one of several brands of yohimbine tablets sold in the US. Yohimex is a prescription drug with 5.4 milligram of yohimbine hydrochloride as the active ingredient, manufactured by Jones Medical Industries in Canton, OH 44702, and distributed by Kramer Laboratories in Miami FL 33174. As Yohimex is a prescription drug, it had to be reviewed by the FDA. It’s hard to believe that if yohimbine were indeed a definite MAO inhibitor, a specific note on the subject matter would be missing from the brochure accompanying every bottle of Yohimex.
Alas, the package literature contains no reference claiming that yohimbine would be a MAO inhibitor. The package literature has the following to say about the clinical pharmacology of yohimbine hydrochloride:
“Yohimbine blocks presynaptic alpha-2 adrenergic receptors. Its action on peripheral blood vessels resembles that of reserpine, though it is weaker and of short duration. Yohimbine’s peripheral autonomic nervous system effect is to increase parasympathetic (cholinergic) and decrease sympathetic (adrenergic) activity. It is to be noted that in male sexual performance, erection is linked to cholinergic activity and to alpha-2 adrenergic blockade which may theoretically result in increased penile inflow, decreased penile outflow or both. Yohimbine exerts a stimulating action upon the mood and may increase anxiety. Such actions have not been adequately studied or related to dosage although they appear to require higher doses of the drug”.
No word on MAO inhibition. The Mosby RxList website also does not mention yohimbine as MAO inhibitor.
(Reserpine is a white to yellowish powder isolated from the roots of certain species of Rauwolfia and used as a sedative and an antihypertensive.)
Well, yohimbine and yohimbe are not exactly the same. Yohimbe is the raw tree bark, and yohimbine is just one of its active ingredients that has been extracted. Even if yohimbine is not a MAO inhibitor, it may still be the case that yohimbe is.
We have seen a number of web sites that claim that either yohimbine or yohimbe is a MAO inhibitor, or that yohimbine isn’t but yohimbe is.
However, we haven’t seen any conclusive study on yohimbe and MAO inhibition. If yohimbe were a strong and definite MAO inhibitor, one would have to expect fatalities if the usual precautions against tyramine-containing foods were not heeded. Any herb that functioned as a definite MAO inhibitor would long ago have been classified as a poison. But yohimbe has been sold as a supplement for years. If incidences of death would have occurred after ingesting yohimbe because of yohimbe being a MAO inhibitor, it’s unlikely this fact would not be reported widely. Alas, there are no widely circulating reports of yohimbe causing deaths because of its effects as MAO inhibitor.
Sure, yohimbe and yohimbine cause side effects, which could be interpreted as an effect of MAO inhibition, mainly nervousness. But yohimbe usually does not cause an increase in blood pressure.
A safe assessment is that even if both yohimbine and yohimbe are not definite MAO inhibitors, they shouldn’t be taken together with MAO inhibitors. I would add that people who are on MAO inhibition medication are anyway not physically well enough to take an additional leisure medication as strong as yohimbe or yohimbine.
Now, while yohimbe and yohimbine are not MAO inhibitors to the extent in which the term “MAO inhibitor” is pharmacologically understood, there is nevertheless some correlation between yohimbine and MAO activity.
It has been documented that yohimbine is an anxiogenic agent, a substance that can induce anxiety in humans and other higher animals. The Yohimex package literature states: “Yohimbine exerts a stimulating action upon the mood and may increase anxiety. Such actions have not been adequately studied or related to dosage although they appear to require higher doses of the drug.”
Anxiety is the missing link between yohimbine / yohimbe and MAO inhibition, and it points to a possible explanation why yohimbine / yohimbe act as aphrodisiacs, apart from facilitating erections.
In 1996, a study on the effects of some anxiogenic agents on brain monoamine oxidase inhibitory activity was conducted at the Department of Pharmacology, Banaras Hindu University, Varanasi, India (Bhattacharya SK; Chakrabarti A; Sandler M; Glover V). The study was done on rats, not on humans, as it involved dosages of yohimbine far too high to be used for sexual stimulation. The study came to the conclusion that in a state of anxiety induced by a sufficiently high dosage of yohimbine, there has been a noticeable increase of MAO-inhibitory activity without specific MAO-inhibitory pharmaceutical agents having been added.
This is of course not surprising as in any stress situation, there will likely be increased epinephrine (adrenaline) activity in any higher animal. Epinephrine activity in the body is regulated twofold: as secretion and as deactivation through chairman MAO. Additional secretion and inhibition of deamination by chairman MAO have comparative effects: an increased epinephrine level, with the typical stress-related symptoms.
A reasonable hypothesis regarding the aphrodisiac properties of yohimbe and yohimbine would probably have to consider the effect of the bark and its active ingredient on the neurotransmitter dopamine. While the usual aim of any treatment with MAO inhibitors is to raise levels of dopamine to control Parkinson’s disease, it has been noted that raised dopamine levels normally also bring about sexual agitation.
The link between dopamine and sexual urge is so strong that scientific studies have been undertaken to check to what extent measurable dopamine levels correlate to sexual perversion (paraphilic disorder).
A 1995 research on “Dopamine and sexual behavior” at the Bernard B. Brodie Department of Neuroscience, University of Cagliari, Italy, came to the following result: “Despite some differences, most studies show that treatments that increase or decrease, respectively, brain dopaminergic activity improve or worsen, respectively, several parameters of copulatory activity, supporting a facilitatory role of dopamine in male sexual behavior.”
And a 1997 study at the Harvard Medical School in Boston on “A monoamine hypothesis for the pathophysiology of paraphilic disorders” drew the following conclusion:
“A monoamine pathophysiological hypothesis for paraphilias in males is based on the following data: (i) the monoamines norepinephrine, dopamine, and serotonin are involved in the appetitive dimension of male sexual behavior in laboratory animals; (ii) data gathered from studying the side effect profiles of antidepressant psychostimulant, and neuroleptic drugs in humans suggest that alteration of central monoamine neurotransmission can have substantial effects on human sexual functioning, including sexual appetite; (iii) monoamine neurotransmitters appear to modulate dimensions of human and animal psychopathology including impulsivity, anxiety, depression, compulsivity, and pro/antisocial behavior, dimensions disturbed in many paraphiliacs; (iv) pharmacological agents that ameliorate psychiatric disorders characterized by the aforementioned characteristics, especially central serotonin enhancing drugs, can ameliorate paraphilic sexual arousal and behavior.”
The study refers to the well-known fact that many medications for Parkinson’s disease, which all aim to increase levels of dopamine, have an increased sexual appetite as a common side effect. Many, but not all Parkinson’s medications are MAO inhibitors. If scientific studies were to be undertaken on any aphrodisiac effect of yohimbine or yohimbe (apart from their well-documented effect of making better erections), they would have to check on what effect yohimbine and yohimbe have on dopamine levels, either through MAO modulation or via any alternative pathway.
MAO inhibitors, generic names and brand names:
benmoxin – Nerusil, Neuralex
echinopsidine iodide – Adepren
etryptamine – Monase
iproclozide – Sinderesin, Sursum
iproniazid – Iprozid, Ipronid, Marsilid, Rivivol, Propilniazida
isocarboxazid – Enerzer, Marplan, Marplon
mebanazine – Actamol
metfendrazine – H.M.-11
moclobamide – Aurorix, Manerix (reversible inhibitor)
nialamide – Espril, Isalazina, Mygal, Niamid, Niaquitil, Nuredal, Psicomidina, Surgex
pargyline – Eudatine, Eutonyl, Tenalin
phenelzine – Nardil, Stinerval, Monofen, Fenelzin, Kalgan, Nardelzine
pheniprazine – Catron, Catroniazide, Cavodil, Fenizin
phenoxypropazine – Drazine
pivhydrazine – Neomarsilid, Tersavid
safrazine – Safra
selegiline, l-deprenyl – Eldeprine, Eldepryl, Jumex, Jumexal, Lesotal, Movergan (selective MAO-B inhibitor)
toloxatone – Hymoryl, Perenum (selective MAO-A inhibitor)
tranylcypromine – Parnate, Sicoton, Transamin, Transapin, Tylciprine