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Re: MAOI and Alpha-2 Antagonist (Yohimbine) Questionmark

Posted by King Vultan on May 29, 2004, at 0:58:50

In reply to MAOI and Alpha-2 Antagonist (Yohimbine) harryp, posted by Questionmark on May 28, 2004, at 16:15:15

> harryp or anyone else: what about yohimbine? Yohimbine is an alpha-2 antagonist. i've taken it about 20 or so times while on Nardil and i have never had any bad reactions yet. i do seem to be somewhat more sensitive to its effects, but not a great deal so. But everything i hear about taking yohimbine with an MAOI is like a "do NOT EVER take yohimbine with an MAOI unless you want your chest and head to explode!" type of statement or something. And certainly it has stimulating properties, but they are different than those of the classical CNS stimulants like amphetamines, cocaine, and caffeine. So what's the conclusion-- is yohimbine dangerous to take with an MAOI, and if so, why? Also, at risk of asking an idiotic question, would yohimbine be helpful at all in alleviating a hypertensive reaction?
> Thanks you brilliant peoples you.

I would be rather concerned taking yohimbine because it is a relatively selective alpha-2 antagonist (selectivity ratio of alpha-2 to alpha-1 blockade of approximately 45:1). As Stahl discusses in "Essential Psychopharmacology", blockading alpha-2 autoreceptors on NE neurons increases the release of NE, while blockading alpha-2 heteroreceptors on serotonin neurons increases the release of 5HT. Considering the considerable amount of stored quantities of each present in someone taking an MAOI, this would appear to potentially be problematic and is likely the reason for the warning about yohimbine.





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