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Yohimbine

Yohimbine is a compound from the bark of an African tree that blocks alpha-2 adrenergic receptors, which loosens a brake on the body's stress-related noradrenaline signaling. People mostly look at it for claustrophobia, where two small trials found phobia symptoms improved when it was added to exposure therapy, though the evidence is limited. Those studies were small, with only 24 participants in total, and other research noted increased anxiety in some people.

Sources: PMID 19223151; PMID 22116378

Best evidence
Grade C
Conditions studied
13
Outcomes
25
Graded outcomes
00100

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

13 conditions

Claustrophobia

Claustrophobia: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Phobia Symptoms

Small Improvement

Improves (the measure goes down)Small effect2 studies24 people

Studies that measured phobia symptoms

Fear of Flying

Fear of Flying: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Phobia Symptoms

Small Improvement

Improves (the measure goes down)Small effect2 studies48 people

Studies that measured phobia symptoms

Body Composition

  • Body Fat: improves
  • Muscle Mass: improves
  • Power Output: improves
Body Composition: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Body Fat

Moderate decrease in body fat during caloric restriction

Improves (the measure goes down)Moderate effect1 study20 people

Studies that measured body fat

Muscle MassImproves (the measure goes up)20 people
Power OutputImproves (the measure goes up)20 people

Male Sexual Dysfunction

  • Erections: improves
  • Penile Girth: improves
  • Testosterone: improves
Male Sexual Dysfunction: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Erections

Small improvement in erectile function

Improves (the measure goes up)Small effect1 study419 people

Studies that measured erections

Penile Girth

Small improvement during erection

Improves (the measure goes up)Small effect18 people
TestosteroneImproves (the measure goes up)1 study18 people

Studies that measured testosterone

Sleep Health

  • Diuresis: improves
  • Plasma Melatonin: improves
Sleep Health: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Diuresis

Mild diuretic effect

Improves (the measure goes up)Small effect1 study10 people

Studies that measured diuresis

Plasma MelatoninImproves (the measure goes up)10 people

Orthostatic Hypotension

  • Orthostatic Hypotension Symptoms: improves
Orthostatic Hypotension: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Orthostatic Hypotension Symptoms

Small Improvement

Improves (the measure goes down)Small effect1 study31 people

Studies that measured orthostatic hypotension symptoms

Soccer Performance

  • Body Fat: improves
  • Muscle Mass: improves
  • Power Output: improves
Soccer Performance: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Body Fat

Moderate Decrease

Improves (the measure goes down)Moderate effect1 study20 people

Studies that measured body fat

Muscle MassImproves (the measure goes up)20 people
Power OutputImproves (the measure goes up)20 people

Mental Resilience

  • Anxiety Symptoms: worsens
  • Cortisol: changes; see studies
  • Heart Rate: changes; see studies
Mental Resilience: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Anxiety Symptoms

ADVERSE: Significant increase in anxiety

Worsens (the measure goes up)Moderate effect24 people
CortisolChanges; see studies1 study24 people

Studies that measured cortisol

Heart RateChanges; see studies1 study24 people

Studies that measured heart rate

Alcohol Use Disorder

  • Alcohol Dependence Symptoms: worsens
  • Cortisol: changes; see studies
  • Anxiety Symptoms: worsens
Alcohol Use Disorder: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Alcohol Dependence Symptoms

ADVERSE: Small worsening of symptoms

Worsens (the measure goes up)Small effect35 people
CortisolChanges; see studies1 study35 people

Studies that measured cortisol

Anxiety SymptomsWorsens (the measure goes up)35 people

Parkinson's Disease

  • Orthostatic Hypotension Symptoms: changes; see studies
Parkinson's Disease: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Orthostatic Hypotension SymptomsChanges; see studies1 study31 people

Studies that measured orthostatic hypotension symptoms

Obesity

  • Gastric Emptying Rate: improves
Obesity: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Gastric Emptying RateImproves (the measure goes up)1 study23 people

Studies that measured gastric emptying rate

Cognitive Improvement

  • Blood Pressure: worsens
  • Cerebral Blood Flow: improves
Cognitive Improvement: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Pressure

Small Detriment

Worsens (the measure goes up)Small effect1 study9 people

Studies that measured blood pressure

Cerebral Blood FlowImproves (the measure goes up)9 people

Autonomic Dysfunction

  • Orthostatic Hypotension Symptoms: changes; see studies
Autonomic Dysfunction: outcomes studied for Yohimbine
GradeOutcomeEffectSizeStudiesPeopleStudies list
Orthostatic Hypotension SymptomsChanges; see studies1 study31 people

Key findings

  • Phobia SymptomsClaustrophobiaImproves (the measure goes down)
  • Body FatBody CompositionImproves (the measure goes down)
  • ErectionsMale Sexual DysfunctionImproves (the measure goes up)

Safety notes in the studies

  • ADVERSE: Significant increase in anxiety
  • ADVERSE: Small worsening of symptoms

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  • Grade C

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Studies cited

11 studies from PubMed

  1. Melatonin responses to clonidine and yohimbine challengesJ Psychiatry Neurosci · PMID 7647083
  2. Psychological and neuroendocrine responses to social stress and to the administration of the alpha-2-receptor antagonist, yohimbine, in highly trained endurance athletes in comparison to untrained healthy controlsPharmacopsychiatry · PMID 21710402
  3. Effects of yohimbine on cerebral blood flow, symptoms, and physiological functions in humansPsychosom Med · PMID 10949101
  4. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trialInt J Impot Res · PMID 11896474
  5. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trialsJ Urol · PMID 9649257
  6. Yohimbine: the effects on body composition and exercise performance in soccer playersRes Sports Med · PMID 17214405
  7. Facilitation of fear extinction in phobic participants with a novel cognitive enhancer: a randomized placebo controlled trial of yohimbine augmentationJ Anxiety Disord · PMID 19223151
  8. Pharmacologically induced alcohol craving in treatment seeking alcoholics correlates with alcoholism severity, but is insensitive to acamprosateNeuropsychopharmacology · PMID 21289601
  9. Effect of anti-obesity drugs promoting energy expenditure, yohimbine and ephedrine, on gastric emptying in obese patientsAliment Pharmacol Ther · PMID 1777550
  10. Comparative efficacy of yohimbine against pyridostigmine for the treatment of orthostatic hypotension in autonomic failureHypertension · PMID 20837887
  11. Does yohimbine hydrochloride facilitate fear extinction in virtual reality treatment of fear of flying? A randomized placebo-controlled trialPsychother Psychosom · PMID 22116378