Relapse to cocaine dependence, even after extended abstinence, involves a number of liability factors including impulsivity (predisposition toward rapid, unplanned reactions to stimuli without regard to negative consequences) and cue reactivity (sensitivity to cues associated with cocaine-taking which can promote cocaine-seeking). These factors have been mechanistically linked to serotonin (5-hydroxytryptamine, 5-HT) signaling through the 5-HT 2A receptor (5-HT 2A R) and 5-HT 2C R; either a selective 5-HT 2A R antagonist or a 5-HT 2C R agonist suppresses impulsivity and cocaine-seeking in preclinical models. We conducted proof-of-concept analyses to evaluate whether a combination of 5-HT 2A R antagonist plus 5-HT 2C R agonist would have synergistic effects over these liability factors for relapse as measured in a 1-choice serial reaction time task and cocaine self-administration/reinstatement assay. Combined administration of a dose of the selective 5-HT 2A R antagonist M100907 plus the 5-HT 2C R agonist WAY163909, each ineffective alone, synergistically suppressed cocaine-induced hyperactivity, inherent and cocaine-evoked impulsive action, as well as cue-and cocaine-primed reinstatement of cocaine-seeking behavior. The identification of synergism between a 5-HT 2A R antagonist plus a 5-HT 2C R agonist to attenuate these factors important in relapse indicates the promise of a bifunctional ligand as an anti-addiction pharmacotherapeutic, setting the stage to develop new ligands with improved efficacy, potency, selectivity, and in vivo profiles over the individual molecules. KEYWORDS: 1-Choice serial reaction time task, 5-HT 2A receptor, 5-HT 2C receptor, cocaine, cue reactivity, impulsivity, self-administration, serotonin D ependence on the psychostimulant cocaine is marked by problematic vulnerability to relapse even years into abstinence. 1,2 Two important liability factors that contribute to relapse are impulsivity (predisposition toward rapid, unplanned reactions to stimuli without regard to negative consequences) 3 and cue reactivity (sensitivity to cues associated with cocaine-taking that can promote cocaine-seeking). 4,5 Impulsivity and cue reactivity appear to be interrelated in human cocaine users, 6 and new pharmacotherapeutic strategies that effectively diminish both are likely to enhance abstinence in the highly vulnerable population of cocaine-dependent individuals.The underlying neurobiology of these liability factors includes a regulatory role for serotonin (5-HT; 5-hydroxytryptamine) neurotransmission. The actions of 5-HT in neurons are transduced by at least 14 subtypes of 5-HT receptors (5-HT X Rs) which are presently grouped into seven families (5-HT 1 R−5-HT 7 R) according to their structural and functional characteristics. 7−9 Selective blockade of the 5-HT 2A R 10−12 or activation of the 5-HT 2C R 10,13,14 consistently reduces impulsivity as measured by premature responses assessed in the 1-or 5-choice serial reaction time (1-or 5-CSRT) task, a preclinical Special Issue: Celebratin...