In Germany, yohimbe is on the Commission E (the country's herbal regulatory agency) list of unapproved herbs because of concerns about the herb's safety and effectiveness. In the United States, the FDA has had a number of reports of seizures and kidney failure following the use of yohimbe bark extract.
 

Yohimbe Bark
 

Yohimbe is not recommended because it has a very narrow therapeutic index. There is a relatively small dosing range--below it, the herb doesn’t work and above it the herb is toxic.

Side effects of normal dosages may include dizziness, nausea, insomnia, anxiety, rapid heartbeat, and increased blood pressure.

As little as 40 mg a day can cause severe side effects, such as dangerous changes in blood pressure, hallucinations, paralysis. Overdose can be fatal.

Because yohimbe blocks the enzyme monoamine oxidase, people taking yohimbe bark extract must avoid all tyramine-containing foods (e.g., liver, cheeses, red wine) and over-the-counter products that contain the ingredient phenylpropanolamine, such as nasal decongestants.

People with kidney or liver disease, stomach ulcers, heart disease, high blood pressure, low blood pressure, post-traumatic stress disorder, and panic disorder should not take yohimbe bark extract.

Yohimbe bark extract should not be taken by pregnant or nursing women, children, or elderly people.

Yohimbe bark extract should not be combined with antidepressant drugs unless under the supervision of a physician.

Yohimbine bark extract has been used to facilitate recall of traumatic memories in the treatment of post traumatic stress disorder (PTSD). Use of yohimbine bark extract outside of therapeutic settings may not be appropriate for persons suffering from PTSD. In pharmacology, yohimbine bark extract is used as a probe for α2-adrenoceptor. In veterinary medicine, yohimbine is used to reverse anesthesia from the drug xylazine in small and large animals.

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