The new generation of serotonergic anxiolytics: possible clinical roles.

Serotonin has been implicated in mediating diverse physiologic and psychologic processes. The anatomy and complex pharmacology of brain-serotonin systems enables this neurotransmitter to broadly affect normal and abnormal behaviors. It appears that serotonin plays a role in multiple psychopathologies, including anxiety, depression, mood disorders, aggressive acting out, alcohol-related syndromes, and disinhibitory disorders characterized by impulsivity. It would not be surprising, therefore, if drugs that alter the dynamics of serotonergic neurotransmission prove to be effective in multiple clinical settings. Such agents may treat broad symptom clusters common to multiple nosologic categories. The new generation of serotonergic anxiolytics, including buspirone, gepirone, ipsapirone, and SM-3997, which interact potently with 5-hydroxytryptamine-1A receptors, may prove to be such symptom cluster drugs. There is a scientific rationale for exploring the clinical utility of these agents in anxiety, depression, mood disorders, aggressive syndromes, and alcohol-related disorders.