PubMed-compiled information sheet
This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.
Compiled from 29 PubMed articles · model: gemma4:31b
Summary
Pausinystalia johimbe is an African evergreen tree whose bark contains the indole alkaloid yohimbine, primarily used for treating erectile dysfunction [PMID:31644013, PMID:8031688].
Background
Pausinystalia johimbe is an evergreen tree native to Africa [PMID:22402817]. Its stem bark is the primary source of the bioactive indole alkaloid yohimbine [PMID:31644013, PMID:22402817].
Traditional uses
It has a rich history of use in traditional medicine as a general tonic, an aphrodisiac, and a performance enhancer [PMID:39758619, PMID:7549534].
Active compounds
The major active compound is yohimbine, an indole alkaloid [PMID:31644013, PMID:22402817]. Other alkaloids found in the bark include rauwolscine and corynanthine [PMID:26391406].
Mechanism of action
Yohimbine primarily acts as an antagonist of alpha-2-adrenergic receptors [PMID:39684567, PMID:8031688]. Additionally, hydroethanolic extracts of the herb have been identified to induce the pregnane X receptor (PXR) [PMID:39758619].
Clinical evidence
Evidence CErectile Dysfunction
Yohimbine appears to have a modest therapeutic benefit over placebo, particularly in essentially psychogenic erectile disorder [PMID:8031688].
Safety & adverse effects
Adverse effects associated with yohimbine include gastrointestinal upset, anxiety, increased blood pressure, headache, agitation, rash, tachycardia, and frequent urination [PMID:19876857]. Severe events include intractable priapism [PMID:19876857], severe acute intoxication leading to death [PMID:33529997], and potential cytotoxicity and inhibition of neuronal activity in vitro [PMID:38191119]. In animal studies (mice), oral administration led to decreased male fertility, chromosomal aberrations, and depletion of DNA and proteins in testicular cells [PMID:16763724].
Drug interactions
Concurrent use of yohimbine with tricyclic antidepressants may increase the risk of hypertension [PMID:10675182]. Extracts of the herb may also induce the pregnane X receptor (PXR), which is implicated in herb-drug interactions [PMID:39758619].
Evidence summary
The evidence consists primarily of reviews, case reports, and in vitro/animal studies. While there is some evidence for modest benefit in psychogenic erectile dysfunction, there are significant reports of severe toxicity and adverse effects.
PubMed sources
- 1.PMID: 10675182 (2000) — Herb-drug interactions. · Lancet (London, England)
- 2.PMID: 31644013 (2012) — Sexual Performance Anxiety. · Sexual medicine reviews
- 3.PMID: 39684567 (2024) — Multifaced Nature of Yohimbine-A Promising Therapeutic Potential or a Risk? · International journal of molecular sciences
- 4.PMID: 33066617 (2020) — Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects. · Pharmaceuticals (Basel, Switzerland)
- 5.PMID: 26391406 (2016) — Pharmaceutical quantities of yohimbine found in dietary supplements in the USA. · Drug testing and analysis