Our studies indicate that increased 5HT2A receptors may be associated with the pathophysiology of bipolar illness and that treatment with lithium further increases the density of 5HT2A receptors. Whether this increase in 5HT2A receptors caused by lithium is associated with its therapeutic mechanism of action is unclear. It is also not clear whether the increase in 5HT2A receptors in bipolar or schizoaffective patients, or in suicidal bipolar or schizoaffective patients, is a trait or state marker.