IS HIGH-DOSE YOHIMBINE HYDROCHLORIDE EFFECTIVE IN THE TREATMENT OF MIXED-TYPE IMPOTENCE - A PROSPECTIVE, RANDOMIZED, CONTROLLED DOUBLE-BLIND CROSSOVER STUDY

Objectives. To determine the effectiveness and safety of high-dose yoh imbine for the treatment of mixed-type impotence. Methods. Twenty-nine patients who had mixed-type impotence diagnosed on the basis of a sex ual history, results of a physical examination, laboratory analysis, a ssessment of the sensory pain threshold of the dorsal nerve of the pen is, and dynamic color Doppler sonography of the cavernosal arteries we re entered into a randomized, double-blind, placebo-controlled, crosso ver comparison of a placebo with high-dose yohimbine hydrochloride (36 mg per day orally). The treatment consisted of two 25-day courses; af ter a 14-day washout period, the patients who initially received the p lacebo for 25 days were switched to yohimbine hydrochloride for 25 day s. Erectile function, ejaculation, interest in sex, physical examinati on findings, blood pressure, pulse rate, weight, and audiovisual sexua l stimulation test were investigated before treatment and at the end o f each drug period. The Mann-Whitney test was used for the statistical analysis. Results. Twenty-seven patients (93%) completed the whole tr eatment schedule. Positive clinical results (complete and partial resp onses) were obtained in 12 cases (44%) at the end of the yohimbine pha se and in 13 (48%) after the placebo period. No statistical difference was indicated. Drug-related adverse effects occurred in 2 patients in the yohimbine group (7%). Conclusions. Yohimbine is no better than pl acebo as a first-line treatment for mixed-type impotence. (C) 1997, El sevier Science Inc.