Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Yohimbine is an alkaloid derived from the bark of the Pausinystalia yohimbe tree and has been traditionally used in West African medicine. Scientifically, yohimbine is known as an alpha-2 adrenergic receptor antagonist. By blocking these receptors, it increases the release of norepinephrine and enhances sympathetic nervous system activity. This pharmacological action forms the basis for its use in supporting the sympathetic nervous system, particularly in the context of increasing alertness, energy expenditure, and sometimes as a treatment for erectile dysfunction.

Clinical evidence supports yohimbine’s effects on sympathetic tone, notably through increased heart rate, blood pressure, and the mobilization of fatty acids. Several studies have demonstrated its ability to enhance sympathetic outflow and promote the "fight or flight" physiological response. However, the clinical applications are limited due to safety concerns: yohimbine can cause anxiety, hypertension, and other adverse effects associated with excessive sympathetic stimulation. The evidence for its use is rated moderate (3/5) since the mechanism is well-established, but practical therapeutic applications are restricted by side effects and lack of robust, large-scale clinical trials for most indications. Regulatory agencies in some countries have also issued warnings or restrictions regarding yohimbine use due to safety risks.

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