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The following discussion applies to the drug yohimbine, rather than the herb yohimbe. All risks of the drug apply to the herb, and there are additional risks to consider as well. For example, as noted above, the amount of yohimbine in a given sample of the herb may not be accurately reflected on the label. 1 Furthermore, additional constituents contained in the herb besides yohimbine might present unique (and unknown) risks of their own.
Yohimbine in any form should not be used by pregnant or nursing women, or those with kidney, liver, or ulcer disease, or high blood pressure. Intake of more than 40 mg a day of yohimbine can cause a severe drop in blood pressure, abdominal pain, fatigue, hallucinations, and paralysis. (Interestingly, lower dosages can cause an increase in blood pressure.) Since 40 mg is not very far above the typical recommended dose, yohimbine has what is known as a "narrow therapeutic index." This means that there is a relatively small dosing range, below which the herb doesn't work and above which it is toxic.
Even when taken in normal dosages, side effects of dizziness, anxiety, hyperstimulation, and nausea are common.
Finally, yohimbine may interact adversely with numerous medications, including tricyclic antidepressants, buproprion, methamphetamine, phenothiazines, clonidine, and other drugs for lowering blood pressure. 2
Interactions You Should Know About
If you are taking:
- Tricyclic antidepressants , bupropion, phenothiazines , clonidine , other drugs for lowering blood pressure, amphetamines or any other central nervous system stimulants: Do not use yohimbine.
- Betz JM, White KD. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Intl. 1995;78(5):1189-1194.
- Charney DS, Heninger GR. Alpha 2-adrenergic and opiate receptor blockade. Synergistic effects on anxiety in healthy subjects. Arch Gen Psychiatry. 43(11):1037-41.