Lithium (Li) is known to be used not only during acute manic psychosis but also acute depressive phase in manic-depression. In the present study, it was attempted to investigate the effect of lithium on catecholamine (CA) secretion from the isolated perfused rat adrenal gland and to clarify the mechanism of its action. Replacement of Na+ (118.4 mM) by lithium in the normal Krebs-bicarbonate solution used to perfuse the gland produced gradually an increased response in the spontaneous catecholamine release, which was peaked at 30 ~ 60 min after its perfusion. Li-Krebs solution was perfused into an adrenal vein for 2 hours in every experiments. Li-Krebs-evoked CA secretory responses were depressed significantly under loading with Ca++-free medium. This CA secretion evoked by lithium loading was also reduced markedly by the pretreatment with nicardipine (10-6 M), TMB-8 (10-5 M) and chlorisondamine (10-6 M) for 20 min, respectively, while was not affected by preloading with a pirenzepine (2 × 10-6 M)-containing Krebs. Na+ pump inhibition by pretreatment with ouabain (10-4 M) for 20 min did make the marked depression in Li-evoked CA secretory responses. Moreover, Li-evoked CA release was also diminished markedly by preloading with tetrodotoxin (5 × 10-7 M)-contaming Krebs for 20 min. All these experimental results taken together suggest that lithium enhances CA secretion in a Ca++-dependent fashion by its accumulation in the adrenomedullary chromaffin cells of the rat, and that this secretory effect may be meidated by a dual mechanism: (i) chromaffin cell depolarization and subsequent opening of voltage-sensitive Ca++ channels and (ii) activation of a [Li]i-[Ca]0 counter-transport system.