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Aim: The purpose of this study was to investigate the role of serotonergic genes in the development of alcohol dependence. The manifestation of alcohol withdrawal symptoms related to serotonergic polymorphisms in alcoholics was also examined. Methods: The role of polymorphisms in the serotonin receptor 1A (5-HT1A), serotonin receptor 2A (5-HT2A), and the serotonin transporter gene (5-HTT) promotor region (5-HTTLPR) in the manifestation of individual alcohol withdrawal symptoms was investigated in 97 Korean male inpatients with alcohol dependence and 76 Korean healthy male subjects. The patient’s alcohol withdrawal symptoms were assessed with the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Results: In the 5-HT1A receptor, the frequency of G– genotype (CC) was significantly higher in patients with alcohol dependence than in normal controls (χ2 = 5.03, p = 0.025). The CIWA-Ar subscale scores of nausea, anxiety, and headache, and total CIWA-Ar scale scores were significantly higher in G+ genotypes (CG+ GG) than in G– genotype (p = 0.005, p = 0.004, p = 0.008, and p = 0.008, respectively). Conclusion: The results suggest that the genetic polymorphism of the 5-HT1A receptor may play a role in alcohol dependence and polymorphisms of serotonergic genes may be important in withdrawal symptoms of patients with alcohol dependence. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]