Talk:Yohimbine/Archive 1

Comment 1
I have used Yohimbe for about 15 years. It enhances sexual appetite. I cannot comment on the benefits of Yohimbe on erectile dysfunction. I once had a doctor prescribe Yohimbe in lieu of the over-the-counter variety, but that was not effective for me. I returned to Yohimbe by Herb Pharma at WFM. I agree Yohimbe may increase my heart rate. —Preceding unsigned comment added by 71.106.118.122 (talk • contribs) --

I believe you are correct. In fact, my feeling is that it is wholly more effective than Viagra, although its mode of action is different. I often think it would seriously compete with Viagra for dollars, if people knew its efficacy.

Comment 2
Why is "Yohimbine" used as a proper noun (capital 'Y') in this article? As far as I can tell, it's not a product name and should be lowercase. -- Mikeblas 18:19, 18 November 2006 (UTC)
 * True. Fixed.

Comment 3
I would like to see a citation for "fact that it has been a proven weight loss and body fat reduction agent "

A comment from a user
I was surprised to read that yohimbine is an "...unproven, treatment for erectile dysfunction.". As a user I can confirm it works. OK I'm a sample of one! It is also inexpensive and available over the counter in France where I buy it. —The preceding unsigned comment was added by Special:Contributions/ (talk) ---

Yes, Sir. It seems as if the more recent burden-of-proof requirements have gotten rather burdensomely stringent. . . . Viagra facilitates the vasodilatation required for erection, but yohimbe clearly and unambiguously facilitates the drive and the desire. It is not subtle. Once, 30 minutes after I had taken only half a tablet, I wondered what was up with Wee Willie Winkie, outstanding as he was in my trousers; then I remembered I had taken yohimbe. I proffer this as anecdotal evidence of a non-psychosomatic mode of action.

MAO Inhibitor
I was told that yohimbine was a mild MAO inhibitor, if this is true it aught to be in the page as a health warning.

What type of MAO inhibitor is important. It would determine an appropriate warning. But I haven't seen much solid evidence of this. Only a lot of speculation. —Preceding unsigned comment added by 71.107.230.145 (talk) 21:35, 11 February 2008 (UTC)

Comment 5
There is no citation for "Yohimbine also antagonizes several serotonin receptor subtypes: 1A (inhibitory, behavioral control" I have googled "5HT1A antagonist" and get no results other than a link to Wikipedia. However, if I Google "5HT1A agonist", I get results that confirm 5HT1A as a partial agonist. I believe that Yohimbine and Yohimbine HCL are either 5HT1 partial agonists or agonists but not 5HT1A antagonists. GoldenBooks (talk) 21:49, 2 August 2008 (UTC)

Mixology section
The mixology section seems to be little more than an advertisement for a restaurant. It is also filled with completely unscientific claims off of a menu from said restaurant. —Preceding unsigned comment added by 70.181.201.50 (talk) 00:46, 16 September 2009 (UTC)

Comment 6
I remember reading somewhere that ephedrine and yohimbine should never under any circumstances be taken together. (IE: They're contraindicated). This combination causes a severe rise in body temperature and over-sensitization to the adrenergic system (ie raising adrenaline levels to extremely dangerous proportions). I can't find an original source at the moment, so I've posted this here for anyone who might be able to help me find that article. Until then, I just wanted to remind people of the dangers of combining medications like these.

Thank you. Simplistic Linguist (talk) 22:08, 27 January 2010 (UTC)

Comment 7
The end of the introduction to the article contains the following statement: "Yohimbine was recently associated as a remedy for type 2 diabetes mellitus in animal and human models carrying polymorphisms of the α2A-adrenergic receptor gene (Rosengren et al epublished in Science, November 19, 2009)." However, the issue of Science cited does not exist (there were issues published on November 13 and 20 of 2009 but not on the 19th) and a search of Pubmed turns-up zero articles linking yohimbine and type 2 diabetes. This should be edited, however my attempts to edit the page have been unsuccessful (I don't appear to have access to this particular section of the text). —Preceding unsigned comment added by Behonick (talk • contribs) 20:54, 6 April 2010 (UTC)

Reply to Comment 7
See below link. It's from the Jan 8 2010 issue of Science and was e-published Nov 19 2009.

http://www.ncbi.nlm.nih.gov/pubmed/19965390

71.81.220.75 (talk) 22:15, 27 June 2016 (UTC)

Surely the wrong word
"Its conservation is difficult because the bioactivity of the tree has led many Western governments to declare it a prescribed species."

Surely the writer meant to indicate that governments prevent its easy availability by imposing legal limitations on its sale and/or use. The word is proscribed. P0M (talk) 18:02, 26 June 2011 (UTC)

Adverse Effects
There should be mention of yohimbine's ability to cause opioid withdrawal symptoms in opioid-dependent people. From personal experience, that is definitely something I would have liked to have known prior to taking yohimbine. ERP — Preceding unsigned comment added by 72.149.241.170 (talk) 15:59, 3 January 2012 (UTC)

Sources of Yohmbine
Article contains nothing on this topic.--Mongreilf (talk) 20:20, 9 October 2014 (UTC)

Weight Loss Section
The section briefly describing that yohimbine has no effects on weight loss may be accurate. It also may not be. There are competing scientific studies on both sides of the issue, but I think the consensus is leaning towards "slightly helps lower body fat when used correctly". It's not very honest to cite just one study for something like this. See http://www.ncbi.nlm.nih.gov/pubmed/17214405 for a convincing counterexample 50.191.22.227 (talk) 04:52, 15 January 2015 (UTC)
 * The issue with the source you cited here is that it's a primary source and per WP:MEDRS guidelines, secondary sources are the standard. If you can find a secondary source that says this from a reputable peer-reviewed medical journal, then that would certainly merit discussion. TylerDurden8823 (talk) 20:12, 8 March 2015 (UTC)
 * Agreed, and that's what I was trying to get at in my original comment though I didn't know the wikipedia guideline -- the current source is only a single primary study as well. 50.191.22.227 (talk) 21:18, 31 May 2015 (UTC)

Sourcing for weight loss
has now twice replaced content sourced to a 2011 secondary (Review) article with a primary source from 2006 "corroborated" by a 2002 primary source (presumably this was done with the aid of a time machine). This is not neutral and runs directly counter to WP:MEDRS. Alexbrn (talk) 18:47, 12 April 2015 (UTC)
 * To the contrary, I replaced it once, and then reverted when my edit was undone. I fixed the "corroborating" language, I had meant to reverse the sentence order, but didn't. In any case let's get to the actual controversy and see if we can come to some conclusion about the article itself... In http://www.corpuscompendium.com/search/label/Fat%20Loss and elsewhere (a simple gsearch) these two (and other) studies, both from reputable, oft-cited, organizations, have similar findings. These particular studies aren't contradicted in the source which I originally reverted. Can you please research the topic and see if you find data which directly contradicts the findings of these, and similar studies? And if so, then the controversy itself would make for a more encyclopedic entry on the topic. - super &beta;&epsilon;&epsilon; cat 18:57, 12 April 2015 (UTC)
 * As an aside, I've re-read wp:3rr, and I am definitely correct. My initial edit was NOT a reversion, we have both reverted a SINGLE time, the warning was inappropriate. - super &beta;&epsilon;&epsilon; cat 19:00, 12 April 2015 (UTC)
 * We don't do research; we summarize accepted knowledge as found in reliable sources (WP:MEDRS is this case). You're elevating your own understanding above that found in more recent expert literature. Alexbrn (talk) 19:01, 12 April 2015 (UTC)
 * I'm (VERY OBVIOUSLY) referring to researching the citations themselves, not Yohimbine's efficacy. Stop being needlessly combative. - super &beta;&epsilon;&epsilon; cat 19:15, 12 April 2015 (UTC)
 * Exactly, it's not your job to seek out primary sources - then sift, evaluate and summarize them - that's what Review articles (secondary sources) do, in an expert reliable way. You deleted the Review article. Alexbrn (talk) 19:19, 12 April 2015 (UTC)
 * That's fair. Normally when I see an edit like this, I look to see if the new information is a better SOURCE (again, not judging the content). Then, I see if I can strengthen the case for the source by adding secondary citations, NOT assume bad faith and remove it. I removed the initial source because I felt my sources were better. I may have (as you have pointed out) lacked in secondary citations. The research I'm referring to is whether or not the sources are better (i.e. used by more reputable authority, more often). In the case that both the original source and the new sources are well cited, then a controversy should appear in the article. Let's get to the bottom of whether there is a controversy in the medical world, and properly cite it. - super &beta;&epsilon;&epsilon; cat 19:25, 12 April 2015 (UTC)
 * (edit) tell ya what - go ahead and revert to the original version, and I'll post a proposed edit here in the talk section, and ping you for your opinion. Cheers. - super &beta;&epsilon;&epsilon; cat 19:27, 12 April 2015 (UTC)
 * There is no controversy: that's your invention. The science is settled (in lieu of later review articles than the 2011 one you deleted). Have you read WP:MEDRS? If so, you'd know you've been replacing a good source with crap ones, as my original ES said. It would be better if you self-reverted. Alexbrn (talk) 19:29, 12 April 2015 (UTC)
 * The science is settled? The review article cited is by a GP and his brother who isn't even a scientist (he's now a forrestry exec after betting his Bsc in biology). The original author they are "reviewing" happens to be a well published, well cited expert in the field: https://scholar.google.ca/citations?user=WiCCywUAAAAJ&hl=en 96.53.76.70 (talk) 21:56, 17 April 2015 (UTC)
 * Please read WP:MEDREV. If you don't know what we mean when we say "secondary source" please read the definitions section, which is just above the MEDREV section.  Thanks. Jytdog (talk) 22:01, 17 April 2015 (UTC)

drug
this article claimed that yohimbine is a drug. (and listed the names of a bunch of dietary supplements as though they were drugs)
 * The only evidence I have found for that, is as an animal drug - see here.
 * A search at the Merck Manual provides nothing.
 * The FDA does say that any OTC product marketed as an aphrodisiac that contains yohimbine is illegal. see here, Sec. 310.528, which says: "Any product that bears labeling claims that it will arouse or increase sexual desire, or that it will improve sexual performance, is an aphrodisiac drug product. Anise, cantharides, don qual, estrogens, fennel, ginseng, golden seal, gotu kola, Korean ginseng, licorice, mandrake, methyltestosterone, minerals, nux vomica, Pega Palo, sarsaparilla, strychnine, testosterone, vitamins, yohimbine, yohimbine hydrochloride, and yohimbinum have been present as ingredients in such drug products.  (note - if a product is labelled as treating or preventing a disease, the FDA calls it a "drug") ...Any OTC drug product that is labeled, represented, or prompted for use as an aphrodisiac is regarded as a new drug within the meaning of section 201(p) of the Federal Food, Drug, and Cosmetic Act, (the act), for which an approved new drug application under section 505 of the act and part 314 of this chapter is required for marketing. In the absence of an approved new drug application, such product is also misbranded under section 502 of the act. ...After January 8, 1990, any such OTC drug product initially introduced or initially delivered for introduction into interstate commerce that is not in compliance with this section is subject to regulatory action."
 * a search of the FDA website shows no drugs approved for human use.


 * can anyone provide a reliable source that yohimbine is a prescription drug for humans in the US or anywhere else?  Jytdog (talk) 10:00, 4 May 2015 (UTC)
 * i made some changes. Jytdog (talk) 14:02, 4 May 2015 (UTC)

erectile dysfunction - dead wrong
I found the following in the article: The NIH states that yohimbine hydrochloride is the standardized form of yohimbine that is available as a prescription medicine in the United States, and that it has been shown in human studies to be effective in the treatment of male erectile dysfunction. The source is to MedlinePlus, and if you look at the headers, you are in a section about Home → Drugs, Herbs and Supplements → Herbs and Supplements → Yohimbe. This is not drug information. Additionally, the section discussing erectile dysfunction says in big bold letters: Insufficient evidence to rate effectiveness for.... this content contradicts its source. Jytdog (talk) 10:08, 4 May 2015 (UTC)

chemistry - synthesis and history sections
sections formerly were as follows: Yohimbine was first isolated from the yohimbe extract in 1896 by Adolph Spiegel. In 1943 the correct constitution of yohimbine was proposed by Witkop. Fifteen years later, Van Tamelen used a 23-step synthesis to become the first person to achieve the synthesis of yohimbine.

The first synthesis of yohimbine occurred in 1958 by the von Tamelen research group. This synthesis was done in 21 steps and was the first successful application of N-acyliminium chemistry in natural product synthesis. In 2011, the synthesis of (+)-Yohimbine via an Enantioselective Organocatalytic Pictet–Spengler Reaction was achieved in nine steps by Herle et.al. The starting product for this reaction is tryptamine. The tryptamine derivative is reacted with methyl 5-oxo-2-(phenylseleno)pentanoate. This product then undergoes an intermolecular Diels-Alder reaction.

Yohimbine biosynthesis can also be achieved from the reaction of tryptamine and secologanin which is catalyzed by the enzyme strictosidine synthase.

For claims about "first", there should be a secondary source that makes that claim (like with the 1914 phama yearbook - that is perfect). citing an article from say 1877 and saying that was the first of something is Original research by the editor who makes that claim. Also, there was no source provided for the synthesis shown in the figure...

I restructured this article today per WP:MEDMOS, as this is an animal drug. MEDMOS does provide space for chemistry so hopefully we can work together to find CONSENSUS on a way to structure the article. My biggest focus this morning was clearing out the confusion about what yohmbine is used for. 17:04, 4 May 2015 (UTC)

About revisions
One of my students made extensive revisions as part of a class assignment in an advanced undergraduate chemistry course. Many of these revisions were removed, for a number of reasons, and many look to be justified. Still, I wanted to make a couple comments about the revisions. In our class, we studied molecules with either confirmed toxicity or potential toxicity. All of these molecules were bioactive in some way, and many were discovered long ago and used in traditional medicine or ritual, before their chemical structures or behaviors were scientifically characterized. Therefore, in editing articles, we thought history and chemistry were important sections to expand. Is there a reason they do not belong in this article? Most other articles about complex molecules do have this information, since they are very important to the fields of chemistry and the history of the molecule (how was it discovered? what organism does it come from? why did chemists bother to isolate it?). This page is (or should be) about yohimbine the molecule, not yohimbine the herbal supplement (who knows what mix of substances is in that), and so, I think the content of the article should focus on the molecule, not the herb. Would love to discuss further. Ajfrontier (talk) 16:44, 4 May 2015 (UTC)

Comments about citations in chemistry section above are helpful. Ajfrontier (talk) 17:19, 4 May 2015 (UTC)
 * :) thanks for posting here. yes i gave a bit of answer above. please do have a look at WP:MEDMOS and let me know if what you want to do can fit in that structure.. btw, i don't know if this is at all of interest to your class, but i wonder about the marketing of this compound as a drug.  i am guessing three things based on some searching i did today: a) this drug was marketed before 1962 and was removed from the market in some indications under the Kefauver Harris Amendment; b) the Kefauver Harris review found some use; c) no company markets this drug anymore as a finished phamaceutical preparation, but you can still get it under prescription via compounding pharmacies.  I could not find really reliable sources for any of that. (there is so much garbage on the internet about the use of supplements for ED... and in general i have found it really hard to track down information on old old drugs like that).  drugs like that are so interesting to me but the information is really hard to come by. (see Stanozolol for an example of where i was able to track down almost the whole story, if you like. that took ages and was old-school library research)  Jytdog (talk) 17:46, 4 May 2015 (UTC)


 * I have a couple ideas: first, I think the article should make it more clear that yohimbe is the plant extract, and yohimbine is the molecule. Pausinystalia johimbe has some discussion about the extract, but this page looks like it needs work. About converting it to the WP:MEDMOS format, I would wish for a place to add traditional/ ritual use, such as the history revision submitted yesterday (not all of it is copied above).  It is a natural substance that was only isolated because it first showed interesting bioactivity in that context.   The suggested revisions to the chemistry section seem simple enough.  I didn't know about the history of yohimbine as a drug- interesting!  In the class, we talk about drugs a little bit, but mostly we focus on toxic substances. Ajfrontier (talk) 22:28, 4 May 2015 (UTC)
 * There is no requirement that this article follow MEDMOS. It would be equally appropriate to consider WP:CHEMMOS (on writing about chemicals) and WP:PHARMMOS (on writing about drugs)—and none of them are required.  The point is to have a decent article, not to shoehorn the content into a suggested format.  WhatamIdoing (talk) 22:55, 4 May 2015 (UTC)

Blanking
It looks like we lost a lot of content in the editing. Here's most of the biggest pieces, with the rationale (if any) given in the edit summary:

unreliable sources

 * 1) Yohimbine’s properties were first witnessed when the Bantu people of West Africa were able to use the bark of the Pausinystalia Yohimbe tree as an aphrodisiac to increase sexual pleasure and prowess. Yohimbe extract was also used as a treatment for fevers, coughs, leprosy, and as a way to cause mild hallucinations. It is probable that yohimbe bark was even imported into ancient Egypt as a herb. This bark has been deemed able to break black magic and witchcraft spells causing impotency in Cameroon. Similarly, the Maasai use the bark of the yohimbe tree as an ingredient in a ritualistic drink. European’s were introduced to the yohimbe extract in the 19th century when German missionaries brought it back to Europe claiming it to be a love tree. The extract was sold in the form of love candies which were popular gifts between lovers.
 * 2) At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with yohimbine.
 * 3) Research on cats suggests that yohimbine increases the effects of catecholaminergic stimulants, namely amphetamine and modafinil.

not MEDRS

 * 1) Yohimbine has been shown to be effective in the treatment of orgasmic dysfunction in men. Yohimbine has also been used to treat hypoactive sexual desire disorder (under active libido) in women.
 * 2) There is potential for yohimbine to be used as treatment for SSRI induced sexual dysfunction. One study has shown yohimbine's ability to increase physical functioning as well as desire in patients taking an SSRI. Yohimbine has proved to be effective in treating dry mouth caused by anti-depressant use, however, much of the evidence has been centered around those taking a tricyclic antidepressant.
 * 3) Yohimbine has been used to facilitate recall of traumatic memories in the treatment of post traumatic stress disorder (PTSD). Use of yohimbine outside of therapeutic settings may not be appropriate for persons suffering from PTSD.

primary source
Yohimbine was explored as a remedy for type 2 diabetes in animal and human models carrying polymorphisms of the α2A-adrenergic receptor gene. A 2002 study looked at the combined effects of yohimbine in conjunction with L-arginine glutamate as a more potent option than yohimbine by itself and for individuals who could not take the newer erectile drugs such as Viagra. The results of this study showed improvement as compared to a placebo. Priliminary studies have also been done on the effects of yohimbine for eople with low blood pressure or those who faint upon standing. These tests have shown promising results but more tests must be done to confirm the results.

offtopic
Therefore, although yohimbe bark has been used traditionally to alleviate male erectile dysfunction, there is not enough scientific evidence to form a definitive conclusion in this area. However, in the 1960’s the FDA conducted studies to test if yohimbine was effective as an aphrodisiac. They found that it was effective as long as the user was not afflicted with organic impotency.

counts for 1% to 20% of total alkaloids. Among them, corynanthine is an α1 receptor blocker. Hence the use of yohimbe extract in sufficient dosages may provide concomitant α1 and α2 receptors blockade and thus may better enhance erections than yohimbine alone. Additionally, it inhibits the function of monoamine oxidase enzymes, although it is not clear if it is a RIMA, MAOA, or MAOB inhibitor. MAOIs are normally contraindicated for use with tyramine-rich food (see the cheese effect). Some companies have combined yohimbine with tyramine in their energy products. However, tyramine failed to potentiate the effect of yohimbine except for somewhat augmenting the increase in DHPG. Despite its MAOI properties, it does not spare the degradation of tryptamines, (e.g. DMT) which remain orally inactive upon coadministration, suggesting that yohimbine is potentially a selective inhibitor of MAOB.

no reason given
Pausinystalia yohimbe can grow up to 30m tall and it characterized by a grey-brown bark which is 4-10mm thick. The bark of the yohimbe tree does not gain high levels of alkaloids until around 15-20 years of age when the bark is composed of 2-15% alkaloids. The yohimbe tree is currently threatened with extinction in its native habitat due to international demand.[citation needed] Its conservation is difficult because the bioactivity of the tree has led many Western governments to declare it a proscribed species.

unsourced
Perceptible effects begin under half a miligram. A typical dose for sexual dysfunction would be 15–30 mg, whereas 100 mg would be considered dangerous. Overdose may also precipitate panic-type reactions, heart attack, and possibly death. Some have experienced severe adverse effects under 5 mg.

offtopic and unsourced
Overdoses of yohimbine can cause priapism. There is little evidence for the use of pseudoephedrine in the treatment of priapism. The America Urology Association recommends phenylephrine intracavernous injection.

It would probably make sense to consider things like whether the information is good, rather than whether the currently cited sources meet the letter of some "law". WhatamIdoing (talk) 23:00, 4 May 2015 (UTC)
 * i really try not to get rid of information that is actually...a) information that is b) relevant to the article. Most of the above was repetitive or kind of bullshitty content hyping dietary supplements for erectile dysfunction.... edit notes could have been better for sure.  is there anything you want to restore? Jytdog (talk) 23:28, 4 May 2015 (UTC)
 * I went ahead and moved the extract stuff out of this article and into the one about the plant. that was  good idea! Jytdog (talk) 12:46, 5 May 2015 (UTC)
 * I think that overdose symptoms ought to be covered, and I'm a little dubious about the current claim that anyone with any psychological disorder at all should avoid it (including, say, mild depression?). The specific ethnopharmacology source (Bantu people) appears to have gotten lost.  It might be worth mentioning the bare fact that research has been done on other diseases (e.g., diabetes and PTSD), perhaps with a statement that there's no good evidence that it works.  WhatamIdoing (talk) 23:20, 6 May 2015 (UTC)

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New section "Yohimbine and yohimbe"
There are separate WP articles on yohimbine and Pausinystalia johimbe, with yohimbe redirecting to the latter. However, yohimbine and yohimbe are often confused in the public mind -- maybe because of their reputations as alleged aphrodisiacs -- and there are safety concerns particularly with yohimbe. So it would be useful to have a fairly brief section where they are discussed together. Their research histories also interact.

Sources: While Betz (2010) and Tam (2001) are good secondary sources satisfying WP:MEDRS, they are not quite ideal in one respect,  namely, being more than 5 years old. However, yohimbine for ED or other sexual enhancement treatment ceased to be a very active field of investigation  quite a few years ago, following the success of  Viagra-type medications. (Betz's 2010 treatment hardly differs from his 1st edition,  2005). Hence Betz and Tam appear to the best non-primary sources presently available, and so should satisfy WP:MEDDATE. Ttocserp (talk) 16:49, 31 January 2019 (UTC)

Research
I have removed the following research section from the article as it contains many medical claims that are not supported by WP:MEDRS compliant secondary sources. Furthermore, per WP:INDISCRIMINATE, this bulleted list of summary-only descriptions of research papers without context and without reference to independent sources is not really appropriate for Wikipedia. Boghog (talk) 11:07, 9 February 2019 (UTC)
 * I shall come back to this tomorrow when I've had time to calm down.Ttocserp (talk) 19:04, 9 February 2019 (UTC)

Drugs of the PDE5 inhibitor class (e.g. Viagra) have largely superseded yohimbine for treating erectile dysfunction (see above). However, Morales (2000) has argued that yohimbine has never been thoroughly and properly investigated for the purpose, because there has not been enough commercial incentive to do so:

"Currently, dose-response investigations are not available, alternative routes of administration (i.e. sublingual) have not been investigated, nor has continuous versus 'on-demand' administration been explored. Synergistic activity with other drugs was last studied nearly four decades ago. Assessment of various populations was carried out in very limited cohorts and only in most general terms.  In short, properly designed trials in humans have not been done.  Why?  Yohimbine is an old drug.  As such it does not enjoy patent protection or commercial viability.  Until molecular/formulation changes can be brought about ... serious investigations of yohimbine will remain in limbo.  It could be that the nay sayers are right and yohimbine, indeed, lacks clinical activity as a treatment for men with erectile dysfunction.  As long as it remains an orphan drug, we will never know."

Yohimbine blocks the pre- and post-synaptic α2 receptors. Blockade of post-synaptic α2 receptors causes only minor corpus cavernosum smooth 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 — thus in the corpus cavernosum — such as nitric oxide and norepinephrine. 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.

Mainly because yohimbine is an alpha-2 adrenergic antagonist, it has been used in a variety of research projects. Some of these turn on the fact that, in appropriately large doses, yohimbine is an anxiogenic. According to modern scientific publications of various dates, yohimbine has been used or investigated:-

Before 1990


 * As an autonomic test drug


 * On noradrenergic hyperactivity as a factor in the production of some anxiety states


 * On the involvement of a2-noradrenergic receptors on opiate withdrawal symptoms and their induction by yohimbine in methadone-receiving patients


 * In the direct characterisation of α2-adrenergic receptors in human lymphocytes


 * On the induction of sexual behaviour in male rats even in the absence of testosterone


 * To reverse immmobilization of polar bears and to reawaken dart-anaesthesised felids in wildlife research
 * As a tool for the subclassification of α-adrenoceptors


 * In the treatment of hypotension in autonomic failure


 * In the conditioned defensive burying paradigm in rats


 * To analyse the interactions of α2‐antagonists with human fat cell α2‐adrenoceptors


 * In the increase of salivary secretion in healthy volunteers


 * In the induction of anxiety in animal tests


 * For counteracting clomipramine‐induced orthostatic hypotension

1990-2000
 * For its bioavailability in humans


 * On the mechanism by which it increases plasma norepinephrine levels


 * On fat distribution in men


 * On supplementary management in the treatment of obesity


 * On lipomobilization in fasting women


 * To evaluate its anxiogenic effects in panic patients


 * On the regulation of noradrenergic function in panic disorder patients


 * To elucidate the site of the dysfunction of the efferent sympathetic pathways in orthostatic hypotension in patients with Parkinson's disease or multiple system atrophy


 * On potentiating neural mechanisms mediating flight or inhibiting mechanisms mediating freezing (mouse model)


 * On working memory in young and aging monkeys


 * On enhancement of morphine analgesia in dental patients


 * On combat-related posttraumatic stress disorder and on the risk to individuals who have PTSD but take yohimbine


 * In the treatment of neurally mediated syncope

2000-2010
 * For the effect of large doses on the functional capacities of the liver and the kidney in the rat model


 * To induce laboratory-measured impulsivity in normal subjects;


 * As a useful probe to predict a subset of young normotensive individuals at genetic risk for hypertension (they display exaggerated increments in catecholamine release and blood pressure when challenged with yohimbine)


 * On stress-precipitated relapse in abstinent cocaine and methamphetamine and heroin users (rat model)


 * On its effects on body composition and exercise performance in elite athletes


 * As a potentiator for the antidepressants fluoxetine and venlafaxine

After 2010
 * On fear extinction in claustrophobic humans and as a therapeutic augmentation strategy for exposure therapy in social anxiety disorder.


 * On the treatment of delayed ejaculation


 * On impaired flexibility in decision-making in rats given large stress-inducing doses


 * As a way to improve the effects of exposure therapy in people with post traumatic stress disorder.

Discussion
Not, in fact, why you did remove it. Without raising it on the talk page, you eliminated an entire 23,000 byte section – containing over 50 cited sources — on 22:50, 8 February 2019 on the then stated ground: "removed entire section that is supported only by primary sources, (cite review, don't write them))".   Those are not the grounds stated on this talk page, now.

I presume that you've actually looked more closely at the cited sources and come to appreciate you were maybe a tad too hasty. Obviously the claim ("entire section that is supported only by primary sources") is untenable or, at best, greatly exaggerated.

So, let's examine your new grounds: but fairly, bearing in mind they're retrospective ie reasons now advanced to defend pretty strong conduct already adopted.

"Contains many medical claims that are not supported by WP:MEDRS compliant secondary sources".


 * From the whole section being blanked out because it was entirely primary sources, we've gone to contains "many' medical claims. "Many"?  Elastic word.  Let's see. Take the first six (or, give me a different six if it's an unfair sample):

"'Mainly because yohimbine is an alpha-2 adrenergic antagonist, it has been used in a variety of research projects. Some of these turn on the fact that, in appropriately large doses, yohimbine is an anxiogenic. According to modern scientific publications of various dates, yohimbine has been used or investigated:-
 * 1. As an autonomic test drug
 * 2. On noradrenergic hyperactivity as a factor in the production of some anxiety states
 * 3. On the involvement of a2-noradrenergic receptors on opiate withdrawal symptoms and their induction by yohimbine in methadone-receiving patients
 * 4. In the direct characterisation of α2-adrenergic receptors in human lymphocytes
 * 5. On the induction of sexual behaviour in male rats even in the absence of testosterone
 * 6. To reverse immmobilization of polar bears and to reawaken dart-anaesthesised felids in wildlife research'"


 * Clearly, reversing immobilization of polar bears in wildlife research, or inducing sex in male rats, are not medical claims.   Nor is use of a research reagent in autonomic testing, or investigating norandregenic hyperactivity: that's clearly scientific research. So is research on the autonomic system that incidentally induced withdrawal symptoms in methadone-receiving patients; or the direct characterisation of α2-adrenergic receptors in human lymphocytes.

As the guideline says, one must use common sense. One must distinguish between (a) medical claims vs. (b) scientific research in biology or biomedicine. One must apply a rule of reason. What's the rationale that's stated for WP:MEDRS? It's this: "Wikipedia's articles are not meant to provide medical advice. Yet, they are widely used among those seeking health information." It is, then, the danger of misleading the health information-seeking lay public that quite properly justifies WP:MEDRS. But it doesn't apply here. Taking even the most borderline case, No. 3, which I did have some doubts about:  Are we going to believe "Gee, I'm a heroin addict on methadone, why don't I get me some yohimbine to cancel out the benefits? "  Not realistic, but anyway, not, in my opinion, a medical claim.

Even if the blanked out section elsewhere does contain some medical claims unsupported by good secondary sources — which presently I do not see — it is no justification for eliminating the whole lot. For that is a blanket decision taken without engaging on the individual merits.

"Furthermore, per WP:INDISCRIMINATE, this bulleted list of summary-only descriptions of research papers without context and reference to independent sources is not really appropriate for Wikipedia."

"Not really appropriate for Wikipedia" is a matter of degree and impression. One editor's opinion scarcely justifies unilateral, undiscussed, wholesale section-blanking. If you'd raised it on the talk page first I'd have tried to engage you fairly on the merits. (I'm still willing.) "Independent sources", in the specific WP:INDISCRIMINATE context, does not mean WP:MEDRS-compliant sources. As science, not medical claims, these research papers are, in my opinion, interesting and relevant. They illustrate the uses of a research agent that has fascinated chemists since 1900. I don't see why you think they're indiscriminate. The unifying theme is stated at the outset, and if you think that explanation isn't good enough, that's the point to address; you're anyway at liberty to improve it.

Now, I have slept on this, and I'll say this. I believe you understand why I'm none too pleased days of careful and laborious editing on my part were wiped out in by you in one fell swoop, as if you owned the article; then came up with different reasons for having done so. As against that, and on reflection, I can see there is some validity in your objections; not as a yes/no overall proposition, but as a matter of degree, nuance and detail; and I'm willing to address them fairly.

So here's an idea: instead of recriminating, why don't we mutually cooperate to improve things? Maybe my list of items is too long. I can see that, for example, the sources could be kept, but just summarised more generally at the beginning, laying off the individual detail in the text. Or there could be other ways. What say you, Boghog?Ttocserp (talk) 10:58, 10 February 2019 (UTC)


 * Thanks for your response. While it is true that secondary sources are not automatically better than primary sources, there has to be very good reasons to cite primary sources (e.g., lack of suitable secondary sources). At least some of the material that you added could have been supported by secondary sources. Furthermore, a shockingly high percentage of research simply cannot be repeated (see Replication crisis). Secondary sources are an independent review of the available primary literature and increases the probability that the results of the research are both reliable and notable.  Finally if there is a research section, IMHO it should be organized by topic (with more background material) rather than chronologically. Boghog (talk) 11:42, 10 February 2019 (UTC)
 * Another thing that troubled me is that secondary sources in the research section were removed with the justification that the sources were outdated. These look like high quality secondary sources that in many cases are more recent than the primary sources that you included.  Hence I have restored these secondary sources (e.g., ) and also restored the Morales review . Boghog (talk) 11:53, 10 February 2019 (UTC)
 * I have marked primary and secondary source in the collapsed section above with the citation parameter Primary/Review. There are several review articles that you have cited (7 out of 51) and I think the addition of these sources would be appropriate. Boghog (talk) 12:47, 10 February 2019 (UTC)


 * Now you have shifted your grounds again! You've dropped WP:MEDRES and "many" medical claims and gone back to "don't use primary sources". Your disquisition on the topic was well meant, though,  and does serve a useful purpose: it shows why you hadn't understood.  Simply, you are making a Rylean category mistake.  Stop rushing to judgement, be patient and see if I can explain it to you.


 * The reliable scientific value of most of the individual research papers in themselves (if you will, their true/false status), is for present purposes largely beside the point. What's relevant is the scientific purpose for which the projects were done. Let's take a concrete example: the first item in the list.  "Mainly because yohimbine is an alpha-2 andrenergic antagonist ... [it] has been used  or investigated:- *1.  As autonomic test drug."
 * Maybe, and for all we know, yohimbine turns out to be pretty poor as an autonomic research drug; or maybe it's the best thing ever devised by the wit of mankind. So what?  The point is, not the efficacy of YOH as an autonomic test drug, but the fact that they tried it in the first place.  That fact, which is a fact like any other, in its turn might be true or false, hence requires verification through a reliable source.  And that is what the Holmberg & Gershorn citation establishes.  If you say that Holberf & Gershon is a primary source, so what?  It's a legitimate use: WP:PRIMARYNOTBAD and WP:PRIMARYCARE.  "Please rimary sources may only be used on Wikipedia to make straightforward, descriptive statements that any educated person − with access to the source but without specialist knowledge − will be able to verify are directly supported by the source."


 * In what way did I exceed or deviate from that rubric? Sure, it would be even better if there was a textbook or encyclopedia called Yohimbine in Biology Research − and use that − but to the best of my knowledge none exists. If you know of a secondary source, go use it: improve  and amend; only, don't just wholesale blank out other editors' work.


 * Maybe there could be a residual objection: that using YOH for that purpose  lacks notability. I don't think so; but in any event (and far more importantly) this is a nuanced value judgement, requiring thought on a case-by-case basis.Ttocserp (talk)


 * I removed e.g. Andersson (2001) from the Clinical section under WP:MEDDATE because we have more recent reviews including Andersson himself; this is uncontroversial and your own subsequent editing of the Clinical section accepts this. I then removed Andersson (2001) from the Research section because it was superfluous: there was already a general statement about ED research, referring back to the Clinical section with its more recent review articles.  True, it was in the Research section, but what purpose did it serve there?  And it might have been taken to boost a medical claim (the jury's still out, chaps, etc).  I can see a justification for keeping Andersson (2001) insofar as he gave relevant information about the nature of the ED research in question.  But you have not used it for that purpose at all.


 * It was you, not I, who removed the Morales citation: when you blanked out the section at 22:50, 8 February 2019. The Morales proposition you excised was to the effect that YOH hadn't been properly researched (explaining where, and what they missed out) and wasn't ever going to be.  But what you have put back is the uninformative and stale clinical proposition as per Andersson.Ttocserp (talk) 22:15, 10 February 2019 (UTC)


 * I am glad you are reading these papers thoroughly.


 * I waited till the end of today in case you had anything further to add. I take it you have not.  Is that a fair inference?  Now, do we take this to adjudication, or do we explore constructive ways to improve this article − the toxicology section leaves very much to be desired − using your undoubted knowledge and diligence and (I hope) mine too?  It would promote a spirit of cooperation if you could bring yourself to see that wholesale, unconsensual blanking out was probably not the best approach in this case.Ttocserp (talk) 22:15, 10 February 2019 (UTC)


 * I meant to add this: You have put back in the Research section a statement of American law which was not quite correct and is not supported by a reliable source. Since we already have a more thorough and well-sourced statement of American law in the Yohimbine and dietary supplements section, what purpose did this serve?Ttocserp (talk) 22:36, 10 February 2019 (UTC)

I have not shifted one bit. MEDRS still applies. No fewer than 12 20 of the bullet points were medical claims (i.e., those that mention healthy volunteers, humans, men, women, patients, athletes, etc.). While the other statements strictly speaking may not be medical claims, the sheer number of them gives the general impression that yohimbine might be useful for medical treatment and that is a problem. Furthermore you are cherry picking Wikipedia guidelines and polices to justify use of primary sources. The important point is that while primary sources are allowed, they need to be used with a high degree of caution. In addition, secondary sources are strongly preferred, especially for biomedical claims. For this material, relevant secondary sources are available and there is no excuse not to use them.

Holmberg & Gershorn is an ancient primary source and per WP:MEDDATE, we need a more up-to-date source. Not only did you remove Andersson 2001, but also Andersson 2011. It was in the research section because there has been extensive research on the use of yohimbine for erectile dysfunction. And it cannot be used to boost medical claim because it clearly states the evidence is insufficient.

Finally the bullet points that you have added are a random collection of facts without context. This material needs to be reorganized by subject supported by reliable secondary sources. Boghog (talk) 07:10, 11 February 2019 (UTC)

I have sorted the articles by subject matter and type of sources. As stated in more detail below, I think a few of these are OK to include, but most are problematic. Boghog (talk) 13:12, 11 February 2019 (UTC)

Supported by review articles (OK to include):
 * On fear extinction in claustrophobic humans and as a therapeutic augmentation strategy for exposure therapy in social anxiety disorder.
 * On the treatment of delayed ejaculation
 * As a way to improve the effects of exposure therapy in people with post traumatic stress disorder.

Veterinary (OK, includes at least one secondary source)
 * To reverse immmobilization of polar bears and to reawaken dart-anaesthesised felids in wildlife researchf

In vitro (may be OK to include, but redundant with the material already presented in the pharmacology section):
 * In the direct characterisation of α2-adrenergic receptors in human lymphocytes
 * As a tool for the subclassification of α-adrenoceptors
 * To analyse the interactions of α2‐antagonists with human fat cell α2‐adrenoceptors

Animal studies (may be OK to include, but much of this is also covered in review articles):
 * On the induction of sexual behaviour in male rats even in the absence of testosterone
 * In the induction of anxiety in animal tests
 * In the conditioned defensive burying paradigm in rats
 * On working memory in young and aging monkeys
 * On potentiating neural mechanisms mediating flight or inhibiting mechanisms mediating freezing (mouse model)
 * For the effect of large doses on the functional capacities of the liver and the kidney in the rat model
 * On stress-precipitated relapse in abstinent cocaine and methamphetamine and heroin users (rat model)
 * As a potentiator for the antidepressants fluoxetine and venlafaxine
 * On impaired flexibility in decision-making in rats given large stress-inducing doses

Humans studies that require secondary sources
 * On the involvement of a2-noradrenergic receptors on opiate withdrawal symptoms and their induction by yohimbine in methadone-receiving patients
 * In the increase of salivary secretion in healthy volunteers
 * For its bioavailability in humans
 * On fat distribution in men
 * On lipomobilization in fasting women
 * To evaluate its anxiogenic effects in panic patients
 * On the regulation of noradrenergic function in panic disorder patients
 * To elucidate the site of the dysfunction of the efferent sympathetic pathways in orthostatic hypotension in patients with Parkinson's disease or multiple system atrophy
 * On enhancement of morphine analgesia in dental patients
 * On combat-related posttraumatic stress disorder and on the risk to individuals who have PTSD but take yohimbine
 * To induce laboratory-measured impulsivity in normal subjects;
 * As a useful probe to predict a subset of young normotensive individuals at genetic risk for hypertension (they display exaggerated increments in catecholamine release and blood pressure when challenged with yohimbine)
 * As an autonomic test drug
 * On noradrenergic hyperactivity as a factor in the production of some anxiety states
 * In the treatment of hypotension in autonomic failure
 * For counteracting clomipramine‐induced orthostatic hypotension
 * On the mechanism by which it increases plasma norepinephrine levels
 * On supplementary management in the treatment of obesity
 * In the treatment of neurally mediated syncope
 * On its effects on body composition and exercise performance in elite athletes

I AM TAKING YOHIMBINUM Q FOR NEARLY A MONTH AND HALF, TWO TIMES A DAY 10 DROPS IN WATER. IT HAS HELPED ME TO GET STRONG ERRECTIONS IN THE MORNING WHICH LAST LONG. I AM 64 YEARS OLD AND HAD FEEBLE ERRECTIONS EARLIER. ROCK§

YOHIMBINUM WORKS
I AM TAKING YOHIMBINUM Q FOR NEARLY A MONTH AND HALF, TWO TIMES A DAY 10 DROPS IN WATER. IT HAS HELPED ME TO GET STRONG ERRECTIONS IN THE MORNING WHICH LAST LONG. I AM 64 YEARS OLD AND HAD FEEBLE ERRECTIONS EARLIER. ROCK§ — Preceding unsigned comment added by 182.68.130.193 (talk) 12:40, 29 March 2019 (UTC)