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Indole therapeutics: Latest FDA updates, ongoing trials, and future directions.

Noor-Ul-Huda Butt, Sultan Nacak Baytas

Drug Discovery Today October 1, 2025 DOI: 10.1016/j.drudis.2025.104471 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Keywords FDA Approvals Cancer Clinical trials Drug development Indole Neurological disorders Viral infectious
Citations 4
Key findings Indole-based compounds have evolved from cytotoxic to targeted anticancer agents, gained prominence as antivirals during the COVID-19 pandemic, and are increasingly explored as neuroactive agents, though indole-based antibiotics remain underrepresented.

Abstract

Indole-based compounds serve as versatile pharmacophores across anticancer, antiviral, neurological, antimicrobial, and metabolic therapies. This review systematically analyses FDA-approved, withdrawn, and investigational indole-containing drugs over the past decade, focusing on evolving clinical outcomes, regulatory decisions, and therapeutic repositioning. It explores the shift from cytotoxic to targeted anticancer agents, the rise of indole-based antivirals in response to the COVID-19 pandemic, and the expanding interest in neuroactive indoles, particularly psychedelic compounds. Additionally, it highlights the underrepresentation of indole-based antibiotics and outlines progress in epigenetic and metabolic modulators. Through a detailed evaluation of pharmacological classes, clinical trial data, and structural characteristics, this review presents a comprehensive framework to guide future optimization and multi-target development of indole scaffolds.