indole
Indole is an aromatic heterocyclic organic compound
In chemistry, organic compounds are generally any chemical compounds that contain carbon-hydrogen or carbon-carbon bonds. Due to carbon's ability to catenate (form chains with other c ...
alkaloid
Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom. This group also includes some related compounds with neutral and even weakly acidic properties. Some synthetic compounds of similar ...
derived from the bark of the African tree ''
Pausinystalia johimbe
''Corynanthe johimbe'', synonym ''Pausinystalia johimbe'', common name yohimbe, is a plant species in the family Rubiaceae native to western and central Africa (Nigeria, Cabinda, Cameroon, Congo-Brazzaville, Gabon, Equatorial Guinea). Extracts ...
''; also from the bark of the unrelated South American tree ''
Aspidosperma quebracho-blanco
''Aspidosperma quebracho-blanco'', commonly known as Quebracho blanco, kebrako, or white quebracho, is a South American tree species, native to Brazil, northern Argentina, Bolivia, Paraguay, and Uruguay. It must not be confused with other specie ...
''. Yohimbine is an α2-adrenergic receptor antagonist, and has been used in a variety of research projects. It is a veterinary drug used to reverse sedation in dogs and deer.
While yohimbine behaves as an
aphrodisiac
An aphrodisiac is a substance that increases sexual desire, sexual attraction, sexual pleasure, or sexual behavior. Substances range from a variety of plants, spices, foods, and synthetic chemicals. Natural aphrodisiacs like cannabis or cocai ...
in some mammals, it does not do so in humans. It has been prescribed as a treatment for erectile dysfunction, although its reported clinical benefits were modest and it has largely been superseded by the
PDE5 inhibitor
A phosphodiesterase type 5 inhibitor (PDE5 inhibitor) is a vasodilating drug that works by blocking the degradative action of cGMP-specific phosphodiesterase type 5 (PDE5) on cyclic GMP in the smooth muscle cells lining the blood vessels supplyi ...
class of drugs. Substances that have purported to be extracts from the yohimbe tree have been marketed as dietary supplements for various purposes, but they contain highly variable amounts of yohimbine, if any; no published scientific evidence supports their efficacy.
Uses
Yohimbine is a drug used in veterinary medicine to reverse the effects of
xylazine
Xylazine is a pharmaceutical drug used for sedation, anesthesia, muscle relaxation, and analgesia in animals such as horses, cattle, and other non-human mammals. Veterinarians also use xylazine as an emetic, especially in cats. It is an anal ...
in dogs and deer. It is used as a research reagent. In the US, it is prescribed, but now rarely, for erectile dysfunction in men.
Yohimbine and yohimbe
Confusion
Yohimbine should not be confused with
yohimbe
''Corynanthe johimbe'', synonym ''Pausinystalia johimbe'', common name yohimbe, is a plant species in the family Rubiaceae native to western and central Africa (Nigeria, Cabinda, Cameroon, Congo-Brazzaville, Gabon, Equatorial Guinea). Extract ...
but often is.
Yohimbe is the common English name for the tree species ''P. johimbe'' (also called ''Corynanthe johimbe'')
and, by extension, the name of a medicinal preparation made from the bark of that tree, sold as an
aphrodisiac
An aphrodisiac is a substance that increases sexual desire, sexual attraction, sexual pleasure, or sexual behavior. Substances range from a variety of plants, spices, foods, and synthetic chemicals. Natural aphrodisiacs like cannabis or cocai ...
. In contrast, yohimbine is a pure alkaloid that can be isolated from yohimbe bark.
Yohimbine is just one of at least 55 indole alkaloids that have been isolated from the bark; and, while it has been described as the most active of these, it constitutes only 15% of the total alkaloid content. Others include
rauwolscine
Rauwolscine, also known as isoyohimbine, α-yohimbine, and corynanthidine, is an alkaloid found in various species within the genera ''Rauvolfia'' and ''Corynanthe'' (including ''Pausinystalia''). It is a stereoisomer of yohimbine. Rauwolscine is ...
,
corynanthine
Corynanthine, also known as rauhimbine, is an alkaloid found in the ''Rauvolfia'' and ''Corynanthe'' (including ''Pausinystalia'') genera of plants. It is one of the two diastereoisomers of yohimbine, the other being rauwolscine. It is also rel ...
and
ajmalicine
Ajmalicine, also known as δ-yohimbine or raubasine, is an antihypertensive drug used in the treatment of high blood pressure. It has been marketed under numerous brand names including Card-Lamuran, Circolene, Cristanyl, Duxil, Duxor, Hydroxysarp ...
; the bark also contains non-alkaloids about which virtually nothing is known.
Yohimbe, thus a complex mixture, has been studied far less thoroughly than yohimbine, the pure compound. Pharmaceutical grade yohimbine is usually presented as the
hydrochloride
In chemistry, a hydrochloride is an acid salt resulting, or regarded as resulting, from the reaction of hydrochloric acid with an organic base (e.g. an amine). An alternative name is chlorhydrate, which comes from French. An archaic alternative n ...
, which is more soluble.
Effect on sexual function
History, research and literature
Yohimbe is used in folk medicine as an
aphrodisiac
An aphrodisiac is a substance that increases sexual desire, sexual attraction, sexual pleasure, or sexual behavior. Substances range from a variety of plants, spices, foods, and synthetic chemicals. Natural aphrodisiacs like cannabis or cocai ...
. In 1900, it attracted scientific interest in Germany, where an initial report claimed that yohimbe exerted a strong aphrodisiacal effect in animals and humans. Attention soon shifted from the plant to its active constituents, particularly yohimbine. According to a 2010 encyclopedia article by Joseph M. Betz of the
National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
:
In contrast, there is a "fairly rich literature on yohimbine".
Subsequent work on yohimbine, while confirming that it behaves as an aphrodisiac in animals, including rats, dogs and golden hamsters, has failed to do so in humans. According to Betz:
Clinical efficacy
Yohimbine has been used to treat female sexual dysfunction, but there are few reported clinical trials and these do not show it to be better than placebo. On treatment for male erectile dysfunction (ED), a review article by Tam ''et al.'' (2001) concluded:
Again according to Betz (2010),
A 2011 review by Andersson said:
Yohimbine has been largely superseded by the
PDE5 inhibitor
A phosphodiesterase type 5 inhibitor (PDE5 inhibitor) is a vasodilating drug that works by blocking the degradative action of cGMP-specific phosphodiesterase type 5 (PDE5) on cyclic GMP in the smooth muscle cells lining the blood vessels supplyi ...
drugs such as sildenafil (Viagra). Prescriptions for it are now rare, and most US pharmaceutical manufacturers have discontinued production of prescription capsules and tablets.
Yohimbine has been found to be effective in treating
delayed ejaculation
Delayed ejaculation (DE) describes a man's inability or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation. Generally, a man can reach orgasm within a few minutes of active thrusting during sexual inter ...
in men
Yohimbine and dietary supplements
In the US, "yohimbe" preparations are sold as a dietary supplements for enhancing
libido
Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
, for weight loss and as aids for bodybuilding; but "There is virtually no published research on yohimbe which supports these or any other claims". Often, these products explicitly claim to contain yohim''bine''.
Cohen et al. found that samples of brands sold in American brick-and-mortar stores contained highly variable amounts of yohimbine, and sometimes none at all. Labelling claims were often misleading. Similar results have been reported by other laboratories for products sold in the U.S., in other countries and on the internet. One study found that many brands of "yohimbe" might not derive from the ''P. johimbe'' tree in the first place. According to yet another source, the yohimbe sold in markets in West Africa, where the tree grows, is frequently adulterated with other species of the genus ''Pausinystalia''; these contain little yohimbine. The amounts of alkaloid found even in genuine ''P. johimbe'' bark vary considerably, depending on the source of the bark (roots, stem, branches, height, etc.).
Some brands sold over-the-counter were found to contain more yohimbine per serving than a standard pharmaceutical dose; yet, in the US, pharmaceuticals are subject to the strict regulatory regime pertaining to medicines. It is illegal to introduce or deliver "drugs" into interstate commerce without the permission of the
FDA
The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
. The FDA has asserted that some yohimbine-containing products are "drugs" because they are so promoted as to show "they are intended for use in the cure, mitigation, treatment or prevention of disease": 21 U.S.C. § 321(g)(1)(B). However the legal position is not entirely straightforward, and as of 1 February 2019 there does not appear to be any record of a successful prosecution.
Because of the lack of reliable scientific data on yohimbe, the European Food Safety Authority Panel on Food Additives determined that it was not possible to conclude on its safety or to establish a health-based guidance value. They wrote:
Extracts and chemistry
Yohimbe (''
Pausinystalia johimbe
''Corynanthe johimbe'', synonym ''Pausinystalia johimbe'', common name yohimbe, is a plant species in the family Rubiaceae native to western and central Africa (Nigeria, Cabinda, Cameroon, Congo-Brazzaville, Gabon, Equatorial Guinea). Extracts ...
'') is a tree that grows in western and central
Africa
Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...
; yohimbine was named as originally extracted from the bark of yohimbe in 1896 by Adolph Spiegel (but see § Aspidosperma quebracho-blanco below). In 1943 the correct constitution of yohimbine was proposed by Witkop. Fifteen years later, a team led by
Eugene van Tamelen
Eugene Earle van Tamelen (July 20, 1925 – December 12, 2009) was an organic chemist who is especially recognized for his contributions to bioorganic chemistry.
van Tamelen published five papers while an undergraduate at Hope College. He con ...
used a 23-step synthesis to become the first persons to achieve the synthesis of yohimbine.
Pharmacology
Yohimbine has high
affinity
Affinity may refer to:
Commerce, finance and law
* Affinity (law), kinship by marriage
* Affinity analysis, a market research and business management technique
* Affinity Credit Union, a Saskatchewan-based credit union
* Affinity Equity Par ...
partial agonist
In pharmacology, partial agonists are drugs that bind to and activate a given receptor, but have only partial efficacy at the receptor relative to a full agonist. They may also be considered ligands which display both agonistic and antagonis ...
at 5-HT1A. Yohimbine interacts with serotonin and dopamine receptors in high concentrations.
Research
Yohimbine has been studied as a way to improve the effects of
exposure therapy
Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thou ...
in people with post traumatic stress disorder (PTSD).
It has also been studied as a potential treatment for erectile dysfunction but there is insufficient evidence to rate its effectiveness. It is illegal in the United States to market an over the counter product containing yohimbine as a treatment for erectile dysfunction without getting FDA approval to do so. Nevertheless, the quantity of yohimbine in dietary supplements, often advertised as promoting sexual function, has been found to overlap with prescription doses of yohimbine.
Yohimbine blocks the pre- and post-synaptic α2 receptors. Blockade of post-synaptic α2 receptors causes only minor corpus cavernosumsmooth muscle relaxation, due to the fact that the majority of adrenoceptors in the corpus cavernosum are of the α1 type. Blockade of pre-synaptic α2 receptors facilitates the release of several neurotransmitters in the central and peripheral
nervous system
In biology, the nervous system is the highly complex part of an animal that coordinates its actions and sensory information by transmitting signals to and from different parts of its body. The nervous system detects environmental changes ...
— thus in the corpus cavernosum — such as nitric oxide and
norepinephrine
Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter. The name "noradrenaline" (from Latin '' ad' ...
. Whereas nitric oxide released in the corpus cavernosum is the major vasodilator contributing to the erectile process, norepinephrine is the major vasoconstrictor through stimulation of α1 receptors on the corpus cavernosum smooth muscle. Under physiologic conditions, however, nitric oxide attenuates norepinephrine vasoconstriction.
Botanical sources of yohimbine; sustainability
''Pausinystalia johimbe''
The traditional source of yohimbine is the bark of the African tree ''P. johimbe''. It has other uses, but the tree is sought out primarily for its bark; in practice, harvesting the bark kills the tree. Tree density is relatively low (average ≈ 4 harvestable trees/hectare). The high demand for medicines based on the bark has led to the tree's over-exploitation. The bark is traded in local markets and, because it is scarce, it is often adulterated with that of other species which contain little yohimbine. The species is becoming endangered.
Around the year 2000,
Cameroon
Cameroon (; french: Cameroun, ff, Kamerun), officially the Republic of Cameroon (french: République du Cameroun, links=no), is a country in west-central Africa. It is bordered by Nigeria to the west and north; Chad to the northeast; the C ...
was shipping ''P. johimbe'' to Europe at the rate of about 100 tonnes annually. Most bark is collected illegally by local people who are paid 150
CFA franc
The CFA franc (french: franc CFA, , Franc of the Financial Community of Africa, originally Franc of the French Colonies in Africa, or colloquially ; abbreviation: F.CFA) is the name of two currencies, the West African CFA franc, used in eight We ...
s per kilo (about US$0.10 per pound) for delivery of pre-dried bark at the roadside. In practice they confuse and mix it with ''P. macroceras'' ("false yohimbe"), a species that contains little yohimbine.
''Aspidosperma quebracho-blanco''
''
Aspidosperma quebracho-blanco
''Aspidosperma quebracho-blanco'', commonly known as Quebracho blanco, kebrako, or white quebracho, is a South American tree species, native to Brazil, northern Argentina, Bolivia, Paraguay, and Uruguay. It must not be confused with other specie ...
'' is an unrelated tree whose common name is ''quebracho blanco''. It is found in large areas of central South America, particularly the
Gran Chaco
The Gran Chaco or Dry Chaco is a sparsely populated, hot and semiarid lowland natural region of the Río de la Plata basin, divided among eastern Bolivia, western Paraguay, northern Argentina, and a portion of the Brazilian states of Mato ...
, where it is often the dominant species in the
canopy
Canopy may refer to:
Plants
* Canopy (biology), aboveground portion of plant community or crop (including forests)
* Canopy (grape), aboveground portion of grapes
Religion and ceremonies
* Baldachin or canopy of state, typically placed over an ...
. It is one of the most widely distributed Argentine arboreal species. Traditionally it was logged for fuel, timber and railway sleepers. While in recent times cattle ranching and soya cultivation have led to considerable habitat loss, and while there is still
illegal logging
Illegal logging is the harvest, transportation, purchase or sale of timber in violation of laws. The harvesting procedure itself may be illegal, including using corruption, corrupt means to gain access to forests; extraction without permission, o ...
, no shortage of the bark is reported. The tree has not been described as endangered: a few members of the genus ''Aspidosperma'' are on the
IUCN Red List
The International Union for Conservation of Nature (IUCN) Red List of Threatened Species, also known as the IUCN Red List or Red Data Book, founded in 1964, is the world's most comprehensive inventory of the global conservation status of biol ...
. but the ''quebracho blanco'' species is not one of them.
In its bark an alkaloid is found which was given the name Quebrachine. In 1914, two scientific papers claimed quebrachine was chemically identical to yohimbine. This was disputed, and the matter long remained in doubt. However, in 1972, Effler and Effler using modern analytical techniques, including mass spectrometry, UV absorption, IR absorption, and
NMR
Nuclear magnetic resonance (NMR) is a physical phenomenon in which nuclei in a strong constant magnetic field are perturbed by a weak oscillating magnetic field (in the near field) and respond by producing an electromagnetic signal with ...
, established that quebrachine and yohimbine are one and the same thing. They wrote:
A range of secondary reference works give 'quebrachine' as a synonym for yohimbine.
Strictly speaking, wrote
George Barger
George Barger FRS FRSE FCS LLD (4 April 1878 – 5 January 1939) was a British chemist.
Life
He was born to an English mother, Eleanor Higginbotham, and Gerrit Barger, a Dutch engineer in Manchester, England.
He was educated at Utrecht and ...
, yohimbine should have been given the scientific name ''quebrachine'', seeing that it was first isolated from the quebracho tree and first named in the scientific literature. However the later work on ''P. yohimbe'' was better known, so the newer name stuck.
Other plants
Yohimbine has also been isolated from other plant genera in the family
Apocynaceae
Apocynaceae (from ''Apocynum'', Greek for "dog-away") is a family of flowering plants that includes trees, shrubs, herbs, stem succulents, and vines, commonly known as the dogbane family, because some taxa were used as dog poison Members of ...
Catharanthus
''Catharanthus'' is a genus of flowering plants in the family Apocynaceae. Like the genus ''Vinca'', they are known commonly as periwinkles. There are eight known species. Seven are endemic to Madagascar, ''
Rauvolfia
''Rauvolfia'' (sometimes spelled ''Rauwolfia'') is a genus of evergreen trees and shrubs, commonly known as devil peppers, in the family Apocynaceae. The genus is named to honor Leonhard Rauwolf. The genus can mainly be found in tropical reg ...
'', ''
Amsonia
''Amsonia'' is a genus of flowering plants in the dogbane family, Apocynaceae, first described as a genus in 1788. It is native primarily to North America with one species in East Asia and another in the eastern Mediterranean
The Mediterra ...
Vinca
''Vinca'' (; Latin: ''vincire'' "to bind, fetter") is a genus of flowering plants in the family Apocynaceae, native to Europe, northwest Africa and southwest Asia. The English name periwinkle is shared with the related genus ''Catharanthus'' (an ...
''; from the family
Loganiaceae
The Loganiaceae are a family of flowering plants classified in order Gentianales. The family includes up to 13 genera, distributed around the world's tropics. There are not any great morphological characteristics to distinguish these taxa from ot ...
(genera ''
Gelsemium
''Gelsemium'' is an Asian and North American genus of flowering plants belonging to family Gelsemiaceae. The genus contains three species of shrubs to straggling or twining climbers. Two species are native to North America, and one to China and ...
'' and ''
Strychnos
''Strychnos'' is a genus of flowering plants, belonging to the family Loganiaceae (sometimes Strychnaceae). The genus includes about 100 accepted species of trees and lianas, and more than 200 that are as yet unresolved. The genus is widely di ...
''); and from the family
Euphorbiaceae
Euphorbiaceae, the spurge family, is a large family of flowering plants. In English, they are also commonly called euphorbias, which is also the name of a genus in the family. Most spurges, such as '' Euphorbia paralias'', are herbs, but some, ...
(genus ''
Alchornea
''Alchornea'' is a plant genus of the family (biology), family Euphorbiaceae first described as a genus in 1788. It is widespread in tropical and subtropical regions of Africa, South Asia, Australia, Latin America, and various oceanic islands. Mo ...
'').
Doping
There was a case in the
World Anti-Doping Agency
The World Anti-Doping Agency (WADA; french: Agence mondiale antidopage, AMA) is a foundation initiated by the International Olympic Committee based in Canada to promote, coordinate, and monitor the fight against drugs in sports. The agency's key ...
practice in 2007, when an athlete, who reportedly consumed Yohimbine prior to a given athletic event, was later tested positive for 19-norandrosterone, which is a prohibited substance. However, WADA did not yet list Yohimbine (which can come into a body via an energy drink, also in a form of pre-workout supplement or fat burnerDoping substances in dietary supplements /ref>) as a prohibited substance, nor did it confirm that its use can increase the endogenous level of anabolic steroids, in particular of 19-norandrostenedione and testosterone.
See also
*
Ajmalicine
Ajmalicine, also known as δ-yohimbine or raubasine, is an antihypertensive drug used in the treatment of high blood pressure. It has been marketed under numerous brand names including Card-Lamuran, Circolene, Cristanyl, Duxil, Duxor, Hydroxysarp ...
Corynanthine
Corynanthine, also known as rauhimbine, is an alkaloid found in the ''Rauvolfia'' and ''Corynanthe'' (including ''Pausinystalia'') genera of plants. It is one of the two diastereoisomers of yohimbine, the other being rauwolscine. It is also rel ...
*
Deserpidine
Deserpidine ( INN) or reserpidine (USAN) is an antihypertensive drug related to reserpine which occurs naturally in ''Rauvolfia
''Rauvolfia'' (sometimes spelled ''Rauwolfia'') is a genus of evergreen trees and shrubs, commonly known as de ...
*
Mitragynine
Mitragynine is an indole-based alkaloid and the most abundant active alkaloid in the Southeast Asian plant ''Mitragyna speciosa'', commonly known as '' kratom.'' The total alkaloid concentration in dried leaves ranges from 0.5 to 1.5%. In Thai va ...
*
Rauwolscine
Rauwolscine, also known as isoyohimbine, α-yohimbine, and corynanthidine, is an alkaloid found in various species within the genera ''Rauvolfia'' and ''Corynanthe'' (including ''Pausinystalia''). It is a stereoisomer of yohimbine. Rauwolscine is ...
*
Spegatrine
Spegatrine is an α1- and α2-adrenergic receptor antagonist isolated from '' Rauvolfia verticillata''. Its dimer dispegatrine has greater antagonist affinity for α-adrenergic receptors.
See also
* Ajmalicine
* Corynanthine
* Rauwolscine
...
*
Reserpine
Reserpine is a drug that is used for the treatment of high blood pressure, usually in combination with a thiazide diuretic or vasodilator. Large clinical trials have shown that combined treatment with reserpine plus a thiazide diuretic reduces m ...