60 anxious neurotic outpatients completed a double-blind comparative 2 week clinical study of the anxiolytic effect of melperone 10 mg t.i.d. and 25 mg t.i.d. versus placebo. The efficacy was assessed by the Hamilton Anxiety Scale and Clinical Global Impressions. At the end of the 1st and the 2nd week of treatment, the reduction in the Hamilton scores was significantly greater in the melperone groups than in the placebo group, but there was no significant difference in the improvement of the two melperone groups. Similar findings were true for the global assessment. The adverse effects recorded were generally mild and transient, tiredness being the most frequent in both the placebo and melperone groups. No laboratory abnormalities were attributable to melperone. A nonsignificant reduction in systolic blood pressure was observed in the melperone groups, probably due to the antianxiety effect. It is concluded that melperone, in low doses, appears to be both safe and effective as an antianxiety agent. The results indicate that melperone could be a realistic alternative to the benzodiazepines.