The spatiotemporal regulation of neurotransmitter transporters involves proteins that interact with their intracellular domains. Using a proteomic approach, we identified several proteins that interact with the C terminus of the serotonin transporter (SERT). These included neuronal nitric oxide synthase (nNOS), a PSD-95/ Disc large/ZO-1 (PDZ) domain-containing protein recruited by the atypical PDZ binding motif of SERT. Coexpression of nNOS with SERT in HEK293 cells decreased SERT cell surface localization and 5-hydroxytryptamine (5-HT) uptake. These effects were absent in cells transfected with SERT mutated in its PDZ motif to prevent physical association with nNOS, and 5-HT uptake was unaffected by activation or inhibition of nNOS enzymatic activity. 5-HT uptake into brain synaptosomes was increased in both nNOS-deficient and wild-type mice i.v. injected with a membrane-permeant peptidyl mimetic of SERT C terminus, which disrupted interaction between SERT and nNOS, suggesting that nNOS reduces SERT activity in vivo. Furthermore, treating cultured mesencephalic neurons with the mimetic peptide similarly increased 5-HT uptake. Reciprocally, indicating that 5-HT uptake stimulates nNOS activity, NO production was enhanced on exposure of cells cotransfected with nNOS and SERT to 5-HT. This effect was abolished by 5-HT uptake inhibitors and absent in cells expressing SERT mutated in its PDZ motif. In conclusion, physical association between nNOS and SERT provides a molecular substrate for their reciprocal functional modulation. In addition to showing that nNOS controls cell surface localization of SERT, these findings provide evidence for regulation of cellular signaling (NO production) by a substrate-carrying transporter.PDZ ͉ proteomic ͉ serotonin uptake S erotonin plays a major role in the regulation of mood, cognition, and motor behavior, and a disruption of serotonergic transmission is implicated in several pathophysiological states, including affective disorders. The activity of serotonergic pathways is critically regulated by the reuptake of 5-HT via the plasma membrane serotonin transporter (SERT), a member of the Na ϩ /Cl Ϫ -dependent transporter family (SLC6) (1, 2). SERT is of major pharmacological and clinical interest inasmuch as it represents the primary target of several widely prescribed antidepressants, including the selective [5-hydroxytryptamine (5-HT)] reuptake inhibitors, citalopram and paroxetine (2-4). Moreover, altered SERT expression or function has been suggested not only in depression, but also in anxious and obsessive-compulsive states, disorders that can likewise be improved by treatment with selective 5-HT reuptake inhibitors (4-6).Over the last 10 years, it has become evident that monoaminergic and other classes of plasma membrane transporters are not isolated proteins ''floating'' within the plasma membrane, but rather are components of protein complexes. These generally incorporate an oligomer (possibly formed of dimers) of the transporter that is physically associated with several i...