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Vesicular monoamine transporters (VMAT) are responsible for the uptake of cytosolic monoamines into synaptic vesicles in monoaminergic neurons. In the central nervous system, vesicular monoamine transporter 2 (VMAT2) is the only transporter that moves cytoplasmic dopamine (DA) into synaptic vesicles. Pharmacologically enhancing DA sequestration by VMAT2, and thus preventing the oxidation of DA, may be a strategy for treating diseases such as Parkinson s disease. The neurotoxicity and addictive properties of various psychostimulants have been attributed, at least partly, to their interference with VMAT2 functions. Therefore, VMAT2 may also be a novel target for the development of treatments for psychostimulant abuse. This book summarizes the possible role of VMAT2 as a therapeutic target and the current understanding of the structure-activity relationship of ligands, including tetrabenazine analogs, ketanserin analogs, and 3-amine-2- phenylpropene with VMAT. The molecular structure of VMAT2 and its relevance to ligand binding and the mechanism of transport of these compounds through VMAT are briefly discussed in this book.