The anticonvulsant and antibipolar drug carbamazepine (CBZ) is known to act as a specific antagonist at adenosine A 1 -receptors. After a 3-week application of CBZ, A 1 -receptors are upregulated in the rat brain. We have investigated the consequences of this upregulation for theThe anticonvulsant drug carbamazepine (CBZ) is known to exert antimanic and prophylactic effects in the treatment of manic-depressive disorders that are clinically equivalent to the well-known properties of lithium salts. CBZ may even have advantages as compared to lithium in the treatment and prophylaxis of schizoaffective and rapid cycling bipolar disorders (for review see Solomon et al. 1995). Among the various pharmacological effects of CBZ, its activity as a specific antagonist at adenosine A 1 receptors (van Calker et al. 1991;Biber et al., 1996) may be particularly important, because this property could lead to alterations in the responsiveness of signal transduction systems in the brain (van Calker et al. 1998), a mechanism believed to be instrumental also to lithium's beneficial effects in affective disorders (for review see Manji et al. 1995).Adenosine A 1 -and A 2 -receptor subtypes were originally distinguished by their differential effects on adenylyl cyclase (van Calker et al. 1978(van Calker et al. , 1979, but more recent findings have revealed coupling of adenosine receptors to other signal transduction systems including phospholipase C (PLC) (Miller and Hoffman 1994;Fredholm et al. 1994). Very often, the coupling of adenosine A 1 -receptors to PLC  is synergistic with the stim- NO . 3 ulation evoked by other receptors, such as ␣ 1 -adrenergic receptors (El-Etr et al. 1989;Biber et al. 1996Biber et al. , 1997, histamine H 1 -receptors (Dickenson and Hill 1994), muscarinic receptors (Biden and Browne 1993), or thyrotropin receptors (Okajima et al. 1995). There are, however, also reports suggesting direct activation of PLC by adenosine A 1 -receptors (Freund et al. 1994;Murthy and Makhlouf 1995).We recently reported that the stimulatory effects of adenosine A 1 -receptors on PLC signaling in primary astrocytes from different brain regions depend upon the expression level of adenosine A 1 -receptor mRNA and protein. Adenosine A 1 -receptor mediated PLC activation was only evident in cultures expressing high receptor numbers but was absent in cultures expressing low numbers of adenosine A 1 -receptors (Biber et al. 1997). We, therefore, hypothesized that upregulation of A 1 -receptors should alter their coupling to second messenger systems. Little is known about the physiological regulation of adenosine A 1 -receptor expression, but available evidence indicates an upregulation of receptor number after chronic treatment with receptor antagonists (Shi et al. 1993;Von Lubitz et al. 1994b). Thus, chronic treatment (3 weeks) with the antagonist CBZ, also results in upregulation of A 1 -receptors in the brain (Daval et al. 1989). We report here that in cultured astrocytes with low basal expression of A 1 -receptors mRNA, upreg...