The Silence of the Lambs soundtrack has only been played a few times at my tabletop. It works well most genres–fantasy, modern, even sci-fi, perhaps.
Howard Shore and the Munich Symphony keeps the moods of suspense and dread throughout. There aren’t many sudden “ups and downs” in the music to jar players out the proper mood.
A game master can cue this soundtrack and let it play all 13 songs throughout his or her game.
“Lambs Screaming” is not a bunch of lambs screaming. No, it was played during Clarice Starling’s final meeting with Hannibal Lecter. There’s a turn in the music near the middle where Clarice reveals her final childhood secret to Lecter.
“The Cellar” is one of the best “belly of the beast” tracks out there, where the hero is at the mercy of the villain.
You can find The Silence of the Lambs soundtrack on Amazon and iTunes.