We have examined the cellular processes underlying the desensitization of the 5-hydroxytryptamine (5-HT) 2A receptor induced by agonist or antagonist exposure. Treatment of C6 glioma cells with either 5-HT or the 5-HT 2A receptor antagonist ketanserin resulted in an attenuation in 5-HT 2A receptor function, specifically the accumulation of inositol phosphates stimulated by the partial agonist quipazine. 5-HT-induced desensitization of the 5-HT 2A receptor involved receptor internalization through a clathrin-and dynamin-dependent process because it was prevented by concanavalin A, monodansylcadaverine, and by expression of the dominant negative mutants -arrestin (319 -418) and dynamin K44A. Although short-term (i.e., 10 min) 5-HT and ketanserin exposure resulted in the same degree of desensitization, ketanserin-induced desensitization was not prevented by these agents and did not involve receptor internalization. In contrast, prolonged ketanserin exposure (i.e., 2 h) resulted in 5-HT 2A receptor internalization through a clathrinand dynamin-dependent process, as was observed after agonist treatment. Inhibitors of protein kinase C or calcium-calmodulin kinase II did not attenuate or prevent 5-HT-induced desensitization of the receptor. 5-HT 2A receptor desensitization induced by 5-HT and prolonged ketanserin treatment, but not by short-term ketanserin treatment, was prevented by the expression of the dominant negative mutant of G protein-coupled receptor kinase (GRK)2, GRK2-K220R, and by an anti-GRK2/3 antibody. Our data indicate a dual mechanism of early and late desensitization by the antagonist ketanserin. Short-term ketanserin treatment reduced the specific binding of the agonist radioligand Desensitization of G protein-coupled receptors occurs during agonist exposure, often in a matter of minutes. Mechanisms underlying the desensitization of many G proteincoupled receptors have been elucidated in part by using the -adrenergic receptor as a prototype (Bunemann and Hosey, 1999). In this "classical" multistep process, the agonist-occupied state of the receptor is phosphorylated by a second messenger-dependent kinase (e.g., protein kinase A) and/or a G protein-coupled receptor kinase (GRK). The binding of an adapter protein, arrestin, leads to uncoupling of the receptor from the G protein and receptor sequestration through clathrin-coated vesicles. The internalization of the receptor is dependent on dynamin, a GTPase that is responsible for pinching off the endocytotic vesicle. Internalized receptors may be returned to the cell surface, or degraded in lysosomes.The 5-hydroxytryptamine (5-HT) 2A receptor has been implicated in the mechanism of action of many psychoactive drugs such as hallucinogens, atypical neuroleptics, and antidepressants. The regulation of the 5-HT 2A receptor, however, does not appear to follow the pattern established for many other G protein-coupled receptors. Repeated administration of agonists (Buckholtz et al., 1988;Anji et al., 2000) as well as antagonists (Blackshear and Sande...