“…The decrease in activity among bipolars is seen only when ill individuals are compared with euthymic patients, and occurs independently of the type of treatment [Li alone (Naylor et al, 1973Nurnberger et al, 1982), antidepressant alone (Nurnberger et al, 1982;Rybakowski et al, 1981), various combinations of drugs (Nurnberger et al, 1982), or ECT alone (Choi et al, 1977)], as well as in unmedicated patients (Naylor et al, 1973Rybakowski et al, 1981). The apparent lack of medication effect is consistent with the observation that lymphocytes obtained from bipolar individuals do not upregulate Na,K-ATPase when exposed to lithium as do cells obtained from normal controls or unaffected family members of bipolar probands (Antia et al, 1992(Antia et al, , 1995Wood et al, 1991). The finding that Na,K-ATPase activity in bipolar patients is not different from that in control is consistent with the interpretation that this is a state-dependent, rather than a trait-related, phenomenon.…”