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Severe Raynaud's phenomenon with yohimbine therapy for erectile dysfunction
Sindhu Johnson1, John Iazzetta, Catharine Dewar
1Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada.
The Journal of Rheumatology
|December 17, 2003
Summary
Yohimbine, used for erectile dysfunction, can paradoxically worsen Raynaud's phenomenon in patients with CREST syndrome. This alpha-2 adrenergic antagonist may exacerbate this specific symptom in susceptible individuals.
Area of Science:
- Pharmacology
- Rheumatology
- Cardiovascular Medicine
Background:
- Yohimbine is an alpha-2 adrenergic antagonist commonly prescribed for erectile dysfunction (ED).
- CREST syndrome is a rare autoimmune disorder characterized by calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia.
Observation:
- A patient diagnosed with CREST syndrome was treated with yohimbine for ED.
- The patient exhibited a paradoxical worsening of Raynaud's phenomenon during yohimbine therapy.
Findings:
- Selective alpha-2 adrenergic antagonism by yohimbine can precipitate or exacerbate Raynaud's phenomenon.
- This adverse effect was observed despite yohimbine's intended use for erectile dysfunction.
Implications:
- Clinicians should exercise caution when prescribing yohimbine to patients with CREST syndrome.
- Further investigation is warranted to understand the mechanism behind yohimbine-induced exacerbation of Raynaud's phenomenon in this patient population.