A binding pocket for thyrotropin-releasing hormone (TRH) within the transmembrane helices of the TRH receptor type 1 (TRH-R1) has been identified based on experimental evidence and computer simulations. To determine the binding site for a competitive inverse agonist, midazolam, three of the four residues that directly contact TRH and other residues that restrain TRH-R1 in an inactive conformation were screened by mutagenesis and binding assays. We found that two residues that directly contact TRH, Asn-110 in transmembrane helix 3 (3.37) and Arg-306 in transmembrane helix 7 (7.39), were important for midazolam binding but another, Tyr-282 in transmembrane helix 6 (6.51), was not. A highly conserved residue, Trp-279 in transmembrane helix 6 (6.48), which was reported to be critical in stabilizing TRH-R1 in an inactive state but not for TRH binding, was critical for midazolam binding. We used our previous model of the unoccupied TRH-R1 to generate a model of the TRH-R1/midazolam complex. The experimental results and the molecular model of the complex suggest that midazolam binds to TRH-R1 within a transmembrane helical pocket that partially overlaps the TRH binding pocket. This result is consistent with the competitive antagonism of midazolam binding. We suggest that the mechanism of inverse agonism effected by midazolam involves its direct interaction with Trp-279, which contributes to the stabilization of the inactive conformation of TRH-R1.Seven transmembrane-spanning receptors (7TMRs) comprise one of the largest protein families in mammalian genomes that transduce a variety of signals across cell-surface membranes to activate numerous cellular responses. Because of the involvement of the 7TMRs in many physiological processes, they have been selected as targets for many therapeutic drugs. All 7TMRs share a putative topological structure, but the molecular details of receptor conformational change upon agonist and inverse agonist binding that lead to activation and inactivation, respectively, have not yet been fully understood. For the last decade, intensive research has been focused on identifying receptor agonist binding sites and the dynamic conformational changes induced upon agonist binding (Osman et al., 1999). However, data about the binding of inverse agonists and the inactivation mechanism of 7TMRs are more limited. Interpretations of the results of these studies have been made more complex because the three-dimensional structure of only a single 7TMR, bovine rhodopsin, has been solved by X-ray crystallography (Palczewski et al., 2000).Thyrotropin-releasing hormone (TRH) is a tripeptide pyroGlu-His-Pro-amide that is synthesized and released from the hypothalamus to regulate pituitary hormone levels. TRH functions as a neurotransmitter/neuromodulator in the central and peripheral nervous systems also. TRH binds to specific 7TMRs, TRH receptors (TRH-Rs), and induces a cellular response through G-protein-related signaling pathways. The three-dimensional structure of TRH receptor subtype-1 (TRH-R1) a...